MARY WONG (NPI# 1417994195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417994195 |
| Entity Type | Individual |
| Full Name | MARY WONG |
| Credential | M.D. |
| Practice Address |
6780 Mayfield Rd Mayfield Hts OH 44124-2203 |
| Mailing Address |
2801 Martin Luther King Jr Dr Cr-11 Cleveland OH 44104-3815 |
| Practice Telephone | 2164494500 |
| Mailing Telephone | 2164486254 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2016-03-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 35.078204 | OH | Allopathic & Osteopathic Physicians |
| Y | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
35.078204 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2216444 | 05 | |
| OH | CARESOURCE | 942460636468 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407172976 | Mary Sk Wong | Acupuncturist | 236 S Garfield Ave, Monterey Park, CA 91754-2904 | 2010-04-08 |
| 1811447444 | Mary Wong | Behavioral Analyst | 139 Hugo St, Apt #3, San Francisco, CA 94122-2738 | 2016-10-06 |
| 1790171106 | Mary Wong | Pathology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2015-04-13 |
| 1588835151 | Mary E Wong | Occupational Therapist | 2 Connecticut St, Suite 100, San Francisco, CA 94107-2451 | 2008-03-21 |
| 1174686497 | Mary Yimling Wong | Nurse Practitioner | 7424 Greenville Ave, Suite 206, Dallas, TX 75231-4534 | 2006-12-18 |
| 1992864839 | Mary Wong | Nurse Practitioner | 2340 Clay St, Ste 537, San Francisco, CA 94115-1932 | 2006-12-06 |
| 1174623284 | Mary L Wong | Pharmacist | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2006-09-25 |
| Street Address |
6780 MAYFIELD RD |
| City | MAYFIELD HTS |
| State | OH |
| Zip Code | 44124-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659379949 | Manorama Zachariah | Obstetrics & Gynecology | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2005-07-11 |
| 1821618786 | Michelle Collins | Respiratory Therapist, Certified | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2020-04-21 |
| 1952943706 | Elizabeth Ashley Gallo | Nurse Practitioner | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2019-10-14 |
| 1528550704 | Rich A. Levine | Pharmacist | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2018-06-04 |
| 1619485877 | Jennifer Harvat | Nurse Anesthetist, Certified Registered | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2018-01-22 |
| 1396253860 | Fayron Talley | Nurse Practitioner | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2018-01-17 |
| 1518478767 | Kathleen Corello | Physician Assistant | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2017-10-16 |
| 1194276675 | Angela Donaldson | Nurse Practitioner | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2016-10-19 |
| 1497200455 | Domonique Wong | Nurse Practitioner | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2016-08-19 |
| 1285087908 | Huan Bui | Physician Assistant | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2016-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104470509 | Marian Rae Barton | Physician Assistant | 6092 Mayfield Rd, Mayfield Heights, OH 44124 | 2019-07-25 |
| 1831669860 | Tameka D. Weaver | Home Health Aide | 1408 Golden Gate Blvd, Mayfield Hts, OH 44124 | 2018-12-03 |
| 1508371238 | Jamila Shafawn Hardy | Counselor | 1320 Washington Blvd, Cleveland, OH 44124 | 2017-12-04 |
| 1134664899 | Sergio Watson | Licensed Practical Nurse | 1131 Irene Rd, Lyndhurst, OH 44124 | 2017-01-04 |
| 1164894424 | Carrie Lynn Rodick | Registered Nurse | 1212 Blanchester, Lyndhurst, OH 44124 | 2015-10-27 |
| 1205205804 | Mary Rose Moore | Nurse Practitioner | 1443 Richmond Road, Lyndhurst, OH 44124 | 2015-09-24 |
| 1154717551 | Hongfei Di | Family Medicine | 5187 Mayfield Rd Ste 102, Lyndhurst, OH 44124 | 2015-04-13 |
| 1558753376 | Taj Amjad Khan | Pediatrics | 32810 Creekside Drive, Pepper Pike, OH 44124 | 2015-03-03 |
| 1902297195 | Marcellus Gliha | Hearing Instrument Specialist | 1438 S.o.m. Center Rd, #101, Mayfield Heights, OH 44124 | 2015-02-10 |
| 1194122051 | Doug Blecher | Counselor | 5512 Kilbourne Dr, Cleveland, OH 44124 | 2014-11-20 |
| Find all providers in zip 44124 | ||||
| Taxonomy Code | 2080P0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093058828 | Marina Khrizman | Pediatrics | 700 Childrens Dr, Columbus, OH 43205-2664 | 2013-03-29 |
| 1114203262 | Mahesh Chikkannaiah | Pediatrics | 1 Childrens Plz, Neurology Department, Dayton, OH 45404-1873 | 2011-11-02 |
| 1376821512 | Mohammed Najjar | Pediatrics | 700 Childrens Dr, Columbus, OH 43205-2664 | 2011-07-21 |
| 1174715593 | Maria Cristina C Victorio | Pediatrics | 1 Perkins Sq, Akron, OH 44308-1063 | 2007-08-10 |
| 1699863084 | Roberta E Bauer | Pediatrics | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2006-10-11 |
| 1265478861 | Irene C Dietz | Pediatrics | 2500 Metrohealth Dr, Mhmc-pediatrics, Cleveland, OH 44109-1900 | 2006-06-21 |
| 1770563462 | Wendelin A Burdo Hartman | Pediatrics | 700 Childrens Dr, Columbus, OH 43205-2664 | 2006-01-19 |
| 1023010907 | Benedicta G Enrile | Pediatrics | 555 S 18th St, Columbus, OH 43205-2654 | 2005-08-11 |
| City | MAYFIELD HTS |
| Zip Code | 44124 |
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| 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.