Provider Demographics
NPI:1174815096
Name:WANG, HAILUN (MD)
Entity Type:Individual
Prefix:
First Name:HAILUN
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 1:21 SOUTH RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2482
Mailing Address - Country:US
Mailing Address - Phone:860-284-4950
Mailing Address - Fax:860-284-4951
Practice Address - Street 1:21 SOUTH RD STE 112
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2482
Practice Address - Country:US
Practice Address - Phone:860-284-4950
Practice Address - Fax:860-284-4951
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457354207Y00000X
CT56771207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology