Provider Demographics
NPI:1508954710
Name:BRAUN, NORMA MAI TSEN WANG (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:MAI TSEN WANG
Last Name:BRAUN
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 1:1090 AMSTERDAM AVE
Mailing Address - Street 2:SUITE 5F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1737
Mailing Address - Country:US
Mailing Address - Phone:212-523-3655
Mailing Address - Fax:212-523-2679
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:CLARK 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-4477
Practice Address - Fax:212-523-4455
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094375174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00555564Medicaid
NY071411Medicare ID - Type Unspecified
NY00555564Medicaid