Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 181802 | NY |
N | 111NI0900X | Internist | 181802 | NY |
N | 207R00000X | Internist | MA49146 | NJ |
N | 111NI0900X | Internist | MA49146 | NJ |
N | 207RA0201X | Internist - Allergy & Immunology | 181802 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | MA49146 | NJ |
NPI | 1487646444 |
---|---|
Provider Name | Dr. Ai-Lan Wang |
First Address | Livingston, NJ 07039-4802 |
Second Address | Livingston, NJ 07039-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01182883 | (05) | NY |
E62023 | (02) |