Healthcare Provider Details

I. General information

NPI: 1619437076
Provider Name (Legal Business Name): XIN ALEXANDER WANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEILL CORNELL INTERNAL MEDICINE ASSOCIATES 505 EAST 70TH STREET
NEW YORK NY
10021
US

IV. Provider business mailing address

WEILL CORNELL INTERNAL MEDICINE ASSOCIATES 505 EAST 70TH STREET
NEW YORK NY
10021
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-3587
  • Fax: 212-746-8051
Mailing address:
  • Phone: 212-746-3587
  • Fax: 212-746-8051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number309447
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: