Individual
GUANG-JI WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
629 MAIN ST, MALDEN, MA 02148-3921
(617) 350-7823
Mailing address
629 MAIN ST, MALDEN, MA 02148-3921
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3715
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0391883
—
MA
01
—
2223768
AETNA
MA
01
—
45722700001
CIGNA
MA
01
—
6176
NEIGHBERHOOD
MA
01
—
762408
TUFTS
MA
05
—
9724630
—
MA
01
—
99321901
NETWORK
MA
01
—
W20319
BLUE CROSS & BLUE SHIELD
MA
01
—
W22016
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
08/31/2006
Last updated
09/23/2011
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