Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 058702 | NY |
N | 1223P0300X | Periodontist | 058702 | NY |
NPI | 1083096986 |
---|---|
Provider Name | Dr. Howard Hao Wang |
First Address | Forest Hills, NY 11375-4757 |
Second Address | Forest Hills, NY 11375-4757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2015 |
Last Update Date | 08/10/2019 |