Provider Demographics
NPI:1679980999
Name:WONG, WAIHAY J (MD PHD)
Entity Type:Individual
Prefix:
First Name:WAIHAY
Middle Name:J
Last Name:WONG
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-7519
Mailing Address - Fax:877-991-4826
Practice Address - Street 1:75 FRANCIS ST DEPT OF
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:215-360-1280
Practice Address - Fax:877-991-4826
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA273775207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology