Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 247960 | MA |
N | 111NI0900X | Internist | 247960 | MA |
Y | 207RH0003X | Hematology & Oncology | 262550 | MA |
N | 2084N0402X | Child Neurologist | 247960 | MA |
NPI | 1003101056 |
---|---|
Provider Name | Nancy Wang |
First Address | Boston, MA 02114-2696 |
Second Address | Boston, MA 02114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 25/06/2018 |