Individual
JEN CHIN WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 E WALNUT ST, LONG BEACH, NY 11561-3515
(516) 889-7447
Mailing address
5 E WALNUT ST, LONG BEACH, NY 11561-3515
(516) 889-7447
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
121901
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00229263
—
NY
Enumeration date
09/01/2006
Last updated
09/29/2010
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