MEDICARE: MS. SHARON B. WANG LCSW

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	1041C0700X	Clinical Social Worker	04567-1	NY

General Provider Information

NPI Number	:	1558380352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON B. WANG LCSW

Provider Business Mailing Address
First Line	:	1620 AVENUE I
Second Line	:	APT. 604
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3050
Country	:	US
Telephone Number	:	718-377-4030
Fax Number	:	718-604-5698

Provider Business Practice Location Address
First Line	:	9413 FLATLANDS AVE
Second Line	:	SUITE 101W
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3726
Country	:	US
Telephone Number	:	917-837-6683
Fax Number	:	718-604-5698

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/03/2010

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