DR. PHILLIP T WONG (NPI# 1164449625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164449625 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP T WONG |
| Credential | D.C. |
| Practice Address |
1109 Atwells Ave Providence RI 02909-4144 |
| Practice Telephone | 4015699488 |
| Mailing Telephone | 4015699488 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | X010778-1 | NY | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 2915 | MA | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | DCP00500 | RI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | BCBSRI | 31387 | 01 |
| RI | BLUE CHIP | 412382 | 01 |
| RI | UNITEDHEALTHCARE | 670397 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417331067 | Phillip Wong | Dentist | 1121 W Michigan St # S110b, Indianapolis, IN 46202-5211 | 2015-07-14 |
| 1952462079 | Phillip Allen Wong | Neuromusculoskeletal Medicine & OMM | 10211 Montgomery Blvd Ne Ste A, Albuquerque, NM 87111-3608 | 2006-12-12 |
| 1588635601 | Phillip John Wong | Optometrist | 818 N Beaver St, Flagstaff, AZ 86001-3106 | 2006-01-27 |
| 1821343930 | Phillip Wong | Pharmacist | 352 W Genesee St, Auburn, NY 13021-3126 | 2012-07-16 |
| 1285882357 | Phillip Wong | Case Manager/Care Coordinator | 25 Chapel St, Suite 901, Brooklyn, NY 11201-1952 | 2008-09-03 |
| 1467489674 | Phillip Wong | Radiology | 2125 Oak Grove Rd, Suite 200, Walnut Creek, CA 94598-2536 | 2006-06-26 |
| Street Address |
1109 ATWELLS AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02909-4144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578021754 | Roberta Bellas Portugal | Registered Nurse | Behave Care, 188 Valley St, Providence, RI 02909 | 2019-03-07 |
| 1912137324 | Catherine Elaine Tuttle | Social Worker | 623 Atwells Avenue, Suite 201, Providence, RI 02909 | 2009-07-20 |
| 1477736452 | City Dental, LLC | Dentist | 314f Pocasset Avenue, Providence, RI 02909 | 2007-12-12 |
| 1245449651 | Walter R. Vandyck | Occupational Therapist | Springfield Middle School, Providene School Department, 152 Springfield St, Providence, RI 02909 | 2007-05-22 |
| 1780805283 | Marcel A Trisvan | Counselor | Codac Providence, 349 Huntington Ave, Providence, RI 02909 | 2007-05-01 |
| 1215153945 | Codac Inc | Peer Specialist | 349 Huntington Ave, Codac Providence, Providence, RI 02909 | 2007-04-18 |
| 1316076342 | Mulak Chiropractic Center Inc | Chiropractor | 411 Broadway, Providence, RI 02909 | 2007-03-05 |
| 1710042742 | Michael Antonio Pensa | Chiropractor | 45 Eagle St Bld J Unit 100, Providence, RI 02909 | 2006-12-27 |
| 1780768234 | Providence Community Action | Case Management | 662 Hartford Avenue, Providence, RI 02909 | 2006-10-24 |
| 1881629608 | Cora Brigid Mayer | Counselor | 623 Atwells Ave., Communities for People, Inc., Providence, RI 02909 | 2006-07-11 |
| Find all providers in zip 02909 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699282426 | Brett Cameron Murdock | Chiropractor | 555 W 100 N Ste C, Providence, UT 84332-9863 | 2018-01-02 |
| 1902108483 | Spencer William Wade | Chiropractor | 565 W 465 N, Suite 140, Providence, UT 84332-4801 | 2010-12-03 |
| 1639495278 | Lighthouse Chiropractic, PC | Chiropractor | 717 Allens Ave, Providence, RI 02905-5412 | 2010-04-07 |
| 1366682759 | Joachim Elias Badway | Chiropractor | 176 Webster Ave, Providence, RI 02909-3829 | 2009-02-25 |
| 1942479969 | Andrew Joseph Lombardi Jr. | Chiropractor | 895 N Main St, Providence, RI 02904-5712 | 2008-02-23 |
| 1023298338 | Back In Motion Inc | Chiropractor | 756 Eddy St, Providence, RI 02903-4931 | 2007-11-05 |
| 1689863474 | Ptw and Cvd Enterprises LLC | Chiropractor | 544a Chalkstone Ave, Providence, RI 02908-3618 | 2007-10-17 |
| 1881719441 | Arianna Iannuccilli | Chiropractor | 248 Atwells Ave, Providence, RI 02903-1529 | 2007-03-20 |
| 1316076342 | Mulak Chiropractic Center Inc | Chiropractor | 411 Broadway, Providence, RI 02909 | 2007-03-05 |
| 1093842684 | Ronald E Clary Jr. | Chiropractor | 180 Whitford Ave, Providence, RI 02908-3360 | 2007-02-28 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02909 |
Please comment or provide details below to improve the information on DR. PHILLIP T WONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.