Healthcare Provider Details

I. General information

NPI: 1760412415
Provider Name (Legal Business Name): WENDY WANG PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YAQUIN WANG PHYSICAL THERAPIST

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6735 HARBISON AVE OXFORD REHABILITATION CENTER
PHILADELPHIA PA
19149
US

IV. Provider business mailing address

6735 HARBISON AVE
PHILADELPHIA PA
19149
US

V. Phone/Fax

Practice location:
  • Phone: 215-725-2000
  • Fax: 215-725-8655
Mailing address:
  • Phone: 215-725-2000
  • Fax: 215-725-8655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015777
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAK000498L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: