Provider Demographics
NPI:1073964656
Name:WANG, YANTING I (MD)
Entity Type:Individual
Prefix:
First Name:YANTING
Middle Name:
Last Name:WANG
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:444 NEPTUNE BLVD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4144
Mailing Address - Country:US
Mailing Address - Phone:732-775-5300
Mailing Address - Fax:732-775-1737
Practice Address - Street 1:444 NEPTUNE BLVD
Practice Address - Street 2:UNIT 2
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4144
Practice Address - Country:US
Practice Address - Phone:732-775-5300
Practice Address - Fax:732-775-1737
Is Sole Proprietor?:No
Enumeration Date:2016-06-25
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA11356000207UN0901X, 207RC0000X
PAMT211920390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program