MEDICARE: EILEEN 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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1891659702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN WANG

Provider Business Mailing Address
First Line	:	620 CHATSWORTH DR
Second Line	:
City	:	AMBLER
State	:	PA
Zip	:	19002-1867
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6787 MARKET ST STE 101
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-1848
Country	:	US
Telephone Number	:	610-352-8000
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ EILEEN WANG ” Practice Location

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