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Individual

CHRISTOPHER MARK WANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
545 E 142ND ST, BRONX, NY 10454-2110
(718) 579-1721
Mailing address
23 WATER GRANT ST, APT 11H, YONKERS, NY 10701-3582

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
147558
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00473029
NY
Enumeration date
08/13/2006
Last updated
10/15/2012
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