Individual
GRACE WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4266 KISSENA BLVD, FLUSHING, NY 11355-3213
(718) 888-7907
Mailing address
13815 68TH DR, FLUSHING, NY 11367-1657
(646) 733-6992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
351968
NY
Other
Enumeration date
08/21/2023
Last updated
12/19/2023
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