EDISON WONG M.D. NPI 1457424392

NPI Information

NPI: 1457424392
Provider Name: EDISON WONG, M.D.
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Individual

Specialization: Pain Medicine

PECOS Registration: Yes

Address:
668 N ORLANDO AVE STE 1010
MAITLAND, FL
ZIP 32751
Phone: (407) 644-0101
Get Directions

Edison Wong, M.D. is a pain medicine physical medicine rehabilitation in Maitland, FL. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. Edison Wong, M.D. NPI is 1457424392. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

668 N ORLANDO AVE STE 1010
MAITLAND, FL
ZIP 32751-460
Phone: (407) 644-0101
Fax: (321) 441-1559

The NPI 1457424392 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/16/2006 and was last updated on 4/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine	81293	MASSACHUSETTS	Yes
2	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine	040751	CONNECTICUT	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	30555	OTHER	MASSACHUSETTS	FALLON
2	758575	OTHER	MASSACHUSETTS	TUFTS
3	972848	OTHER	MASSACHUSETTS	NETWORK HEALTH
4	J31343	OTHER	MASSACHUSETTS	BCBS
5	P00132480	OTHER	MASSACHUSETTS	MR RR
6	3139875	MEDICAID	MASSACHUSETTS
7	80911	OTHER	MASSACHUSETTS	HARV PILGRIM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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