Healthcare Provider Details

I. General information

NPI: 1366626228
Provider Name (Legal Business Name): WL MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 2ND AVE SUITE 6A
NEW YORK NY
10017-4502
US

IV. Provider business mailing address

820 2ND AVE SUITE 6A
NEW YORK NY
10017-4502
US

V. Phone/Fax

Practice location:
  • Phone: 212-867-6681
  • Fax: 347-332-1651
Mailing address:
  • Phone: 212-867-6681
  • Fax: 347-332-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number234541
License Number StateNY

VIII. Authorized Official

Name: LIMENG WANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-867-6681