=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790626331
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YING CHUN WANG RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2026
-----------------------------------------------------
Last Update Date | 04/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 89 VALLEY RD
-----------------------------------------------------
City | MONTCLAIR
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07042-2212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-628-7300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 MULBERRY LN
-----------------------------------------------------
City | MOUNT ARLINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07856-1398
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-902-9005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0121X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Registered Nurse
-----------------------------------------------------
License Number | 26NR25872300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------