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General NPI Number Information
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NPI Number | 1053018374
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Entity Type | Organization
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Legal Business Name | AIJUAN WANG MEDICINE PLLC
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 228 BEACH 20TH ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-3618
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Country | US
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Telephone | 833-424-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 2 LINCOLN HWY STE 500
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City | EDISON
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State | NJ
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Zip | 08820-3961
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HUMAN RESOURCES DIRECTOR
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Name | MRS. IRENA MUSHEEV
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Credential | HR
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Telephone | 718-350-5680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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