Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F337981-1 | NY |
NPI | 1003255662 |
---|---|
Provider Name | Mrs. Yingzi Wang |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 26/02/2018 |