Provider Demographics
NPI:1245405471
Name:WANG, REED (LAC, MD)
Entity Type:Individual
Prefix:
First Name:REED
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:LAC, MD
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Mailing Address - Street 1:444 BEDFORD ST
Mailing Address - Street 2:SUITE 8E
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1516
Mailing Address - Country:US
Mailing Address - Phone:203-826-8699
Mailing Address - Fax:203-826-8699
Practice Address - Street 1:129 KINGS HWY N
Practice Address - Street 2:TOP LEVEL
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-2438
Practice Address - Country:US
Practice Address - Phone:212-810-1268
Practice Address - Fax:203-226-4777
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT000341171100000X
NY002943171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist