MEDICARE: YAXIN WANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1194671669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAXIN WANG

Provider Business Mailing Address
First Line	:	1241 N FRONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-4743
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1241 N FRONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-4743
Country	:	US
Telephone Number	:	267-807-0550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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Directions to “ YAXIN WANG ” Practice Location

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