Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086X0206X | Surgical Oncologist | 055725 | CT |
N | 2086X0206X | Surgical Oncologist | 253156 | NY |
Y | 2086X0206X | Surgical Oncologist | C2-0009849 | DE |
NPI | 1023254273 |
---|---|
Provider Name | Chia-Chi Wang |
First Address | Middletown, CT 06457-3654 |
Second Address | Middletown, CT 06457-4700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2008 |
Last Update Date | 12/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03112190 | (05) | NY |