Individual
LARRY WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
220 PASSAIC ST, GARFIELD, NJ 07026-1374
(973) 405-2542
Mailing address
1049 KINGSLAND LN, FORT LEE, NJ 07024-1619
(646) 675-1016
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00683800
NJ
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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