Provider Demographics
NPI:1811964968
Name:WONG, KIT YUE (MD)
Entity type:Individual
Prefix:DR
First Name:KIT YUE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIT YUE
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:163 MAIN ST STE 6D
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1533
Mailing Address - Country:US
Mailing Address - Phone:617-599-4746
Mailing Address - Fax:617-848-2620
Practice Address - Street 1:163 MAIN ST STE 6D
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1533
Practice Address - Country:US
Practice Address - Phone:617-599-4746
Practice Address - Fax:617-848-2620
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2173012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110126670AMedicaid