Basic Information
| Provider Information | |||||||||
| NPI: | 1467437632 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WONG | ||||||||
| FirstName: | ALFONSO | ||||||||
| MiddleName: | CIELO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 HOT METAL ST | ||||||||
| Address2: | QUANTUM ONE BUILDING, SUITE 001 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152032348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126473087 | ||||||||
| FaxNumber: | 4126474486 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 MARY ST | ||||||||
| Address2: | SUITE 2500 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152032054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123812599 | ||||||||
| FaxNumber: | 4124885256 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2005 | ||||||||
| LastUpdateDate: | 12/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD031838L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 250072 | 01 | PA | UPMC | OTHER | 83808 | 01 | PA | UNISON | OTHER | 1528440 | 01 | PA | GATEWAY | OTHER | 574252 | 01 | PA | HIGHMARK BCBS | OTHER | 0009514930009 | 05 | PA | MEDICAID | 2520678 | 05 | OH | MEDICAID |