Healthcare Provider Details

I. General information

NPI: 1780211755
Provider Name (Legal Business Name): SHUHAN WANG MD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHLOE SHUHAN WANG MD, MBA

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 BROADWAY
NEW YORK NY
10007-2019
US

IV. Provider business mailing address

147 NEW BROADWAY
SLEEPY HOLLOW NY
10591-1721
US

V. Phone/Fax

Practice location:
  • Phone: 646-596-7386
  • Fax:
Mailing address:
  • Phone: 347-972-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME176612
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA12226000
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number331718
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: