MEDICARE: MINGKE WANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	244614	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548469778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINGKE WANG M.D.

Provider Business Mailing Address
First Line	:	139 CENTRE ST STE 818
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-4558
Country	:	US
Telephone Number	:	646-590-6735
Fax Number	:	646-590-6737

Provider Business Practice Location Address
First Line	:	139 CENTRE ST STE 818
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-4558
Country	:	US
Telephone Number	:	646-590-6735
Fax Number	:	646-590-6737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	03/02/2023

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