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General NPI Number Information
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NPI Number | 1316720022
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Entity Type | Individual
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Provider Name | CHEN WANG
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Gender | Female
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 13620 MAPLE AVE STE 203
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City | FLUSHING
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State | NY
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Zip | 11355-5167
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Country | US
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Telephone | 718-886-7998
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Fax |
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Provider Business Mailing Address
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Address Line | 13606 SW 117TH LN
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City | MIAMI
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State | FL
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Zip | 33186-4438
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Country | US
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Telephone | 214-354-4458
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F352487-01
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License Number State | NY
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