Provider Demographics
NPI:1093794828
Name:WANG, FEI (MD)
Entity Type:Individual
Prefix:DR
First Name:FEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13235 41ST RD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4113
Mailing Address - Country:US
Mailing Address - Phone:718-886-1080
Mailing Address - Fax:718-886-1081
Practice Address - Street 1:13235 41ST RD
Practice Address - Street 2:SUITE 2C
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4113
Practice Address - Country:US
Practice Address - Phone:718-886-1080
Practice Address - Fax:718-886-1081
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226707207Q00000X, 207U00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02357959Medicaid
NY02357959Medicaid
NYH79340Medicare UPIN
NY06876GMedicare ID - Type UnspecifiedMEDICARE