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General NPI Number Information
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NPI Number | 1174767321
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Entity Type | Individual
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Provider Name | BIANJIANG WANG LAC
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Gender | Female
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 125 SUNRISE HWY
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City | W. ISLIP
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State | NY
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Zip | 11795
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Country | US
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Telephone | 917-376-9289
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Fax |
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Provider Business Mailing Address
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Address Line | 38 E. RIDGEWOOD AVE. #113
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City | RIDGEWOOD
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State | NJ
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Zip | 07450
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Country | US
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Telephone | 917-376-9289
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 002372
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 002372
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License Number State | NY
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