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General NPI Number Information
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NPI Number | 1427358076
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Entity Type | Individual
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Provider Name | MARY Y WANG CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2010
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3400 CIVIC CENTER BLVD WEST PAVILION, 3RD FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19104-5127
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Country | US
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Telephone | 215-662-2891
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Fax | 215-662-6734
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Provider Business Mailing Address
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Address Line | 800 WALNUT ST 19TH FL
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5567
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Country | US
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Telephone | 215-662-2891
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Fax | 215-662-6734
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | SP010960
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License Number State | PA
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