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DR. BONNIE WONG PHD

Clinical Neuropsychologist

Boston, Massachusetts

Provider NPI: 1215964853

Provider Information:
DR. BONNIE  WONG PHD
Gender: F
Not Sole Proprietor

Practice Location:
BIDMC/BEHAVIORAL NEUROLOGY UNIT, 2ND FL 330 BROOKLINE AVENUE BOSTON, MA 02215 US
Tel: 617-667-4068  Fax: --

Business Mailing Address:
106 ADDINGTON RD #2 BROOKLINE, MA 02445 US
Tel: 617-283-9739  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MA8414

Other Provider Identifiers:

IssuerNumberStateType
0599077MA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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