Provider Demographics
NPI:1356465322
Name:WANG, LI SHENG (LAC)
Entity Type:Individual
Prefix:DR
First Name:LI SHENG
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10431 ACADEMY RD
Mailing Address - Street 2:UNIT F
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1126
Mailing Address - Country:US
Mailing Address - Phone:215-612-0889
Mailing Address - Fax:215-612-0889
Practice Address - Street 1:10431 ACADEMY RD
Practice Address - Street 2:UNIT F
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1126
Practice Address - Country:US
Practice Address - Phone:215-612-0889
Practice Address - Fax:215-612-0889
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000733171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist