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General NPI Number Information
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NPI Number | 1205267457
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Entity Type | Organization
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Legal Business Name | EIGHTH AVENUE ANESTHESIA PLLC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 717 56TH ST
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City | BROOKLYN
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State | NY
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Zip | 11220-3503
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Country | US
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Telephone | 718-435-3890
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Fax |
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Provider Business Mailing Address
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Address Line | 8766 23RD AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-5202
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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 | CO-OWNER
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Name | CHANGZHENG WANG
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Credential | M.D.
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Telephone | 908-922-6797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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