Provider Demographics
NPI:1346683299
Name:FANG, WEIYA
Entity Type:Individual
Prefix:MS
First Name:WEIYA
Middle Name:
Last Name:FANG
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:WEIYA
Other - Middle Name:
Other - Last Name:FANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:38 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1103
Mailing Address - Country:US
Mailing Address - Phone:862-701-2023
Mailing Address - Fax:
Practice Address - Street 1:38 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1103
Practice Address - Country:US
Practice Address - Phone:862-701-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00122900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist