Wong, Ivan
Wong, Ivan is an individual health care provider with primary practice located at 7 Backus Ave Ste 250 , Danbury CT 06810-7493. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Wong, Ivan can be contacted via phone (203) 743-9897.Contact Information
Primary practice address
7 Backus Ave Ste 250
Danbury CT 06810-7493
Phone: (203) 743-9897
Fax: (203) 743-6419
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | CT002529 | Connecticut |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | CT002529 | Connecticut |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | CT2529 | Connecticut |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | CT2529 | Connecticut |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | CT002529 | Connecticut |
Profile Details
| NPI number | 1023170073 |
|---|---|
| LBN Legal business name | Wong, Ivan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2006 |
| Last updated | Oct 22nd, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023170073 | NPPES |
| Connecticut | Other | 09002529CT01 | ANTHEM BLUE CROSS BLUE SH |
| Connecticut | Other | 7058856 | ANTHEM BLUE CROSS BLUE SH |
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