Healthcare Provider Details

I. General information

NPI: 1457879421
Provider Name (Legal Business Name): ABIGAIL YICHEN WANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 06/25/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5725 FORWARD AVE STE 401
PITTSBURGH PA
15217-2255
US

IV. Provider business mailing address

1215 LEE ST MAILBOX 801210
CHARLOTTESVILLE VA
22908-4494
US

V. Phone/Fax

Practice location:
  • Phone: 412-214-0042
  • Fax: 412-385-2468
Mailing address:
  • Phone: 434-924-5314
  • Fax: 434-243-4743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD490179
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: