Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 226707 | NY |
N | 207U00000X | Nuclear Medicine Specialist | 226707 | NY |
N | 208D00000X | General Practice Physician | 226707 | NY |
NPI | 1093794828 |
---|---|
Provider Name | Dr. Fei Wang |
First Address | Flushing, NY 11355-4113 |
Second Address | Flushing, NY 11355-4113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 24/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02357959 | (05) | NY |
H79340 | (02) | NY |