Individual
DR. QIANG GARY FANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
423 E 23RD ST # PM&R, NEW YORK, NY 10010-5011
(646) 251-2952
(212) 951-6359
Mailing address
151 TUDOR OVAL, WESTFIELD, NJ 07090-2244
(646) 251-2952
(212) 951-6359
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
220607
NY
208100000X
Physical Medicine & Rehabilitation Physician
25MA11648000
NJ
208100000X
Physical Medicine & Rehabilitation Physician
A81489
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02148754
—
NY
Enumeration date
03/21/2006
Last updated
03/21/2023
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