Provider Demographics
NPI:1306923255
Name:WON, CHRISTINE H (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:H
Last Name:WON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:POB 208057
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8057
Mailing Address - Country:US
Mailing Address - Phone:203-785-4163
Mailing Address - Fax:203-785-3634
Practice Address - Street 1:40 TEMPLE ST STE 3C
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2715
Practice Address - Country:US
Practice Address - Phone:203-764-6788
Practice Address - Fax:203-764-6787
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82080207R00000X
CT48025207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A820800Medicaid
CT48025Medicaid
CT48025OtherMEDICARE ID-UNSPECIFIED
00A820800Medicare ID - Type Unspecified
CT48025Medicaid