1780859785 NPI number — GINA KAM WANG MD LLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780859785 NPI number — GINA KAM WANG MD LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GINA KAM WANG MD LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780859785
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 EAST 22ND STREET
Provider Second Line Business Mailing Address:
SUITE DR 5
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-682-3602
Provider Business Mailing Address Fax Number:
212-213-8060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 EAST 22ND STREET
Provider Second Line Business Practice Location Address:
SUITE DR5
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-682-3602
Provider Business Practice Location Address Fax Number:
212-213-8060
Provider Enumeration Date:
04/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WANG
Authorized Official First Name:
GINA
Authorized Official Middle Name:
KAM
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
212-682-3602

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  187800 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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