Healthcare Provider Details

I. General information

NPI: 1942429634
Provider Name (Legal Business Name): JOHN J WANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 N BEDFORD RD
MOUNT KISCO NY
10549-2553
US

IV. Provider business mailing address

118 N BEDFORD RD
MOUNT KISCO NY
10549-2553
US

V. Phone/Fax

Practice location:
  • Phone: 914-864-3337
  • Fax: 914-214-1282
Mailing address:
  • Phone: 914-864-3337
  • Fax: 914-214-1282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number232014
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: