Provider Demographics
NPI:1083780753
Name:WANG, CECILIA SAIXI (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:SAIXI
Last Name:WANG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 HAMBURG TPKE
Mailing Address - Street 2:SUITE M
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6251
Mailing Address - Country:US
Mailing Address - Phone:973-839-2945
Mailing Address - Fax:973-839-1244
Practice Address - Street 1:2035 HAMBURG TPKE
Practice Address - Street 2:SUITE M
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6251
Practice Address - Country:US
Practice Address - Phone:973-839-2945
Practice Address - Fax:973-839-1244
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0818432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0144321Medicaid
NJI68560Medicare UPIN
NJ0144321Medicaid