Provider Demographics
NPI:1215396700
Name:WAN, BELINDA KAM-LIN (RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:KAM-LIN
Last Name:WAN
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:MS
Other - First Name:BELINDA
Other - Middle Name:KAM-LIN
Other - Last Name:CHENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:160 WEST 100TH STREET
Mailing Address - Street 2:RM #226
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5145
Mailing Address - Country:US
Mailing Address - Phone:646-364-0763
Mailing Address - Fax:646-364-0780
Practice Address - Street 1:100 HESTER STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5293
Practice Address - Country:US
Practice Address - Phone:212-274-9506
Practice Address - Fax:212-274-9506
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338351-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse