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General NPI Number Information
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NPI Number | 1659917037
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Entity Type | Individual
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Provider Name | LING WANG LAC
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Gender | Male
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 2 HILLSIDE AVE STE E
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2308
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Country | US
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Telephone | 516-614-9296
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Fax | 718-539-6471
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Provider Business Mailing Address
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Address Line | 5 TERRACE CIR APT 1F
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City | GREAT NECK
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State | NY
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Zip | 11021-4119
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Country | US
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Telephone | 347-925-9848
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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 | 006640
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 006640
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License Number State | NY
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