Active NPI
Karen Clark Wong, M.D.
- Pediatrics Physician
- Lakewood, NJ
National Provider Identifier
1760496707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MA06805800
- Practice address
- 450 E Kennedy Blvd
Lakewood, NJ 08701-1435 - Phone
- (732) 901-0050
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA06805800 | NJ | Primary |
Addresses
Primary practice location
450 E Kennedy Blvd
Lakewood, NJ 08701-1435
Mailing address
450 E Kennedy Blvd
Lakewood, NJ 08701-1488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA06805800 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1760496707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 E KENNEDY BLVD",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087011488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 E KENNEDY BLVD",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087011435",
"telephone_number": "732-901-0050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "KAREN",
"middle_name": "CLARK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA06805800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.