Provider Demographics
NPI:1558466375
Name:WANG, JOHN HSIANG-YEOU (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HSIANG-YEOU
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:NICOLLS RD AND HEALTH SCIENCES DR INTERSECTION
Mailing Address - Street 2:STONY BROOK UNIVERSITY HOSPITAL, HSC T18-020
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-1045
Mailing Address - Fax:
Practice Address - Street 1:NICOLLS RD AND HEALTH SCIENCES DR INTERSECTION
Practice Address - Street 2:STONY BROOK UNIVERSITY HOSPITAL, HSC T18-020
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-1045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA910852086S0102X
NY2247062086S0102X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A910850Medicaid
H98231Medicare UPIN
CA00A910850Medicaid