Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MA59743 | NJ |
NPI | 1194790550 |
---|---|
Provider Name | Dr. Belle Wang |
First Address | Emerson, NJ 07630-1368 |
Second Address | Emerson, NJ 07630-1368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G19644 | (02) | NJ |