Provider Demographics
NPI:1932455227
Name:WONG, ADRIENNE (MD, RCPSC)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:MD, RCPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:SUITE 519
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-4654
Mailing Address - Fax:412-647-2080
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:SUITE 519
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-4654
Practice Address - Fax:412-647-2080
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD444538207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology