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General NPI Number Information
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NPI Number | 1780859785
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Entity Type | Organization
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Legal Business Name | GINA KAM WANG MD LLP
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 235 EAST 22ND STREET SUITE DR5
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City | NEW YORK
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State | NY
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Zip | 10010
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Country | US
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Telephone | 212-682-3602
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Fax | 212-213-8060
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Provider Business Mailing Address
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Address Line | 235 EAST 22ND STREET SUITE DR 5
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City | NEW YORK
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State | NY
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Zip | 10010
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Country | US
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Telephone | 212-682-3602
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Fax | 212-213-8060
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Authorized Official
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Title or Position | OWNER
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Name | DR. GINA KAM WANG
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Credential | M.D.
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Telephone | 212-682-3602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 187800
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License Number State | NY
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