Basic Information
| Provider Information | |||||||||
| NPI: | 1679806863 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WONG | ||||||||
| FirstName: | SHE-YAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 N CEDAR CREST BLVD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108212828 | ||||||||
| FaxNumber: | 6108217915 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 N CEDAR CREST BLVD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108212828 | ||||||||
| FaxNumber: | 6108217915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2009 | ||||||||
| LastUpdateDate: | 05/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MT200969 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.