Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 275058 | NY |
Y | 2086S0102X | Surgical Critical Care | 275058 | NY |
NPI | 1306116934 |
---|---|
Provider Name | Jennifer Wang |
First Address | New York, NY 10029 |
Second Address | New York, NY 10029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2012 |
Last Update Date | 04/12/2020 |