Organization
LE-BEN WAN MD PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LE-BEN WAN MD (PRESIDENT)
(929) 322-4236
Entity
Organization
Contact information
Practice address
4402 23RD ST STE 504, LONG ISLAND CITY, NY 11101-5072
(929) 322-4236
Mailing address
4402 23RD ST STE 504, LONG ISLAND CITY, NY 11101-5072
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
261874
NY
Other
Enumeration date
08/28/2017
Last updated
12/24/2017
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