1831358134 NPI number — DANNY C WANG MD, MPH

Table of content: DANNY C WANG MD, MPH (NPI 1831358134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831358134 NPI number — DANNY C WANG MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WANG
Provider First Name:
DANNY
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
M

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:
1831358134
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2833 WYNSUM AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRICK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11566-5408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-650-5999
Provider Business Mailing Address Fax Number:
717-812-2244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2833 WYNSUM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERRICK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11566-5408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-650-5999
Provider Business Practice Location Address Fax Number:
717-812-2244
Provider Enumeration Date:
06/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  260040 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0204X , with the licence number: 260040 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0204X , with the licence number: MD445965 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 30120393 . This is a "AMERIHEALTH MERCY - WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 418503 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2711042 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 056654300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1607763 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 102723210 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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