MEDICARE: JESSICA LAN WANG OD

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	152W00000X	Optometrist	9768T	TX

General Provider Information

NPI Number	:	1497314355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LAN WANG OD

Provider Business Mailing Address
First Line	:	2830 JACKSON AVE APT 48F
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3326
Country	:	US
Telephone Number	:	469-230-0666
Fax Number	:

Provider Business Practice Location Address
First Line	:	2830 JACKSON AVE APT 48F
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3326
Country	:	US
Telephone Number	:	469-230-0666
Fax Number	:

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

Provider Enumeration Date	:	06/12/2019
Last Update Date	:	06/12/2019

Similar Medicare Providers

1770997488 — STEPHANIE TOWNE
Practice Location Address:

3319 ISLAND RD
WANTAGH, NY
11793-3326

Practice Phone: 516-330-7039
Practice Fax: 516-977-1679

1013884394 — MOUREN MEGALY
Practice Location Address:

697 ARDEN AVE
STATEN ISLAND, NY
10312-3326

Practice Phone: 347-638-5494
Practice Fax:

1063666865 — MRS. JENNIFER MURRAY BUONOCORE MS, OTR/L
Practice Location Address:

310 NATIONAL BLVD
LONG BEACH, NY
11561-3326

Practice Phone: 516-431-2929
Practice Fax: 516-431-6278

1497024319 — MS. NICOLE HEATHER O'NEILL
Practice Location Address:

310 NATIONAL BLVD
LONG BEACH, NY
11561-3326

Practice Phone: 516-431-2929
Practice Fax: 516-431-6278

1780954255 — MS. AVIVIT SHALOM
Practice Location Address:

310 NATIONAL BLVD
LONG BEACH, NY
11561-3326

Practice Phone: 516-431-2929
Practice Fax:

1760809420 — DANIELLA KAUFMAN
Practice Location Address:

310 NATIONAL BLVD
LONG BEACH, NY
11561-3326

Practice Phone: 516-431-2929
Practice Fax:

Directions to “ JESSICA LAN WANG OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.