Provider Demographics
NPI:1083819916
Name:CHIANG, WENDY M (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:M
Last Name:CHIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-0180
Mailing Address - Country:US
Mailing Address - Phone:973-869-9712
Mailing Address - Fax:
Practice Address - Street 1:1 HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-1016
Practice Address - Country:US
Practice Address - Phone:973-869-9712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243793207RH0003X
NY263735207RH0003X
NJ25MA09216500207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1083819916Medicaid
MA002622001Medicare PIN