Individual
DR. JIAN WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
151 KNOLLCROFT RD, EXTENDED CARE LINE, LYONS, NJ 07019
(832) 766-3990
Mailing address
645 WILLOW GROVE RD, WESTFIELD, NJ 07090-3519
(832) 766-3990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M5568
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
25MA08379000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186598202
—
TX
05
—
K3204660
—
TX
Enumeration date
12/13/2006
Last updated
09/17/2008
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