Healthcare Provider Details

I. General information

NPI: 1912438607
Provider Name (Legal Business Name): YUN HSIANG WANG MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PARK AVE
FLORHAM PARK NJ
07932-1049
US

IV. Provider business mailing address

5815 202ND ST
OAKLAND GARDENS NY
11364-1630
US

V. Phone/Fax

Practice location:
  • Phone: 973-404-9980
  • Fax: 973-267-7295
Mailing address:
  • Phone: 917-915-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA11293300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: