Provider Demographics
NPI:1942819412
Name:WONG, HILLARY HIU WAI (RDN, LDN, CLC)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:HIU WAI
Last Name:WONG
Suffix:
Gender:F
Credentials:RDN, LDN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1532
Mailing Address - Country:US
Mailing Address - Phone:617-347-5544
Mailing Address - Fax:
Practice Address - Street 1:23 PERKINS ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1532
Practice Address - Country:US
Practice Address - Phone:617-347-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA86060888133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered