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General NPI Number Information
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NPI Number | 1336663343
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Entity Type | Organization
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Legal Business Name | Q. T. WANG, MD. NEUROLOGY PC
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | SKYVIEW MEDICAL CENTER, SUITE E-08 131-07 40TH RD
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 410-227-1708
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Fax |
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Provider Business Mailing Address
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Address Line | 3 GATE HOUSE LN
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City | MAMARONECK
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State | NY
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Zip | 10543-1012
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Country | US
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Telephone | 410-227-1708
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. QINGLIANG TONY WANG
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Credential | MD., PHD
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Telephone | 410-227-1708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number | 252321
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 252321
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 252321
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License Number State | NY
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