MEDICARE: MARINA 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	163W00000X	Registered Nurse	956855	NY

General Provider Information

NPI Number	:	1235088600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA WANG

Provider Business Mailing Address
First Line	:	22914 64TH AVE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2413
Country	:	US
Telephone Number	:	718-532-6885
Fax Number	:

Provider Business Practice Location Address
First Line	:	22914 64TH AVE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2413
Country	:	US
Telephone Number	:	718-532-6885
Fax Number	:

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

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “ MARINA WANG ” Practice Location

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