Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 059502 | NY |
NPI | 1043626732 |
---|---|
Provider Name | Dr. Charles Wei |
First Address | Astoria, NY 11106-1712 |
Second Address | New York, NY 10032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2014 |
Last Update Date | 11/07/2018 |