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NPI Code Detail

MEDICARE: JIA WANG

MEDICARE: JIA 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
1171100000XAcupuncturist007761-01NY

General Provider Information

NPI Number : 1821971011
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIA WANG
Provider Business Mailing Address
First Line : 5327 196TH ST
Second Line : FRESH MEADOWS
City : FRESH MEADOWS
State : NY
Zip : 11365
Country : US
Telephone Number : 347-691-8363
Fax Number :
Provider Business Practice Location Address
First Line : 707 MIDDLE NECK RD
Second Line :
City : GREAT NECK
State : NY
Zip : 11024-1935
Country : US
Telephone Number : 347-691-8363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2025
Last Update Date : 01/08/2026

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Directions to “ JIA WANG ” Practice Location

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