Healthcare Provider Details

I. General information

NPI: 1730356080
Provider Name (Legal Business Name): WANG'S MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5423 7TH AVE
BROOKLYN NY
11220-3122
US

IV. Provider business mailing address

5423 7TH AVE
BROOKLYN NY
11220-3122
US

V. Phone/Fax

Practice location:
  • Phone: 718-871-8885
  • Fax: 718-871-8883
Mailing address:
  • Phone: 718-871-8885
  • Fax: 718-871-8883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number240727
License Number StateNY

VIII. Authorized Official

Name: ZHAO H. WANG
Title or Position: MD
Credential:
Phone: 718-871-8885