Provider Demographics
NPI:1164613667
Name:HE, GANG (MD, PHD, FCAP)
Entity Type:Individual
Prefix:
First Name:GANG
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:MD, PHD, FCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 SHAFTER AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1822
Mailing Address - Country:US
Mailing Address - Phone:614-599-5973
Mailing Address - Fax:718-279-1092
Practice Address - Street 1:4534 BELL BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3353
Practice Address - Country:US
Practice Address - Phone:718-279-1271
Practice Address - Fax:718-279-1092
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258638-1207ZP0101X
OH35.090298207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology