Healthcare Provider Details

I. General information

NPI: 1376464057
Provider Name (Legal Business Name): WENHAN JIANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WILL JIANG

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 146TH ST
FLUSHING NY
11354-2324
US

IV. Provider business mailing address

170 E STATION SQUARE DR APT 375
PITTSBURGH PA
15219-1235
US

V. Phone/Fax

Practice location:
  • Phone: 718-962-0888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: