Provider Demographics
NPI:1568421998
Name:WANG, WEN LIN (DO)
Entity Type:Individual
Prefix:DR
First Name:WEN
Middle Name:LIN
Last Name:WANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:160 HUMMINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2506
Mailing Address - Country:US
Mailing Address - Phone:718-358-1728
Mailing Address - Fax:866-923-4356
Practice Address - Street 1:6829 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5046
Practice Address - Country:US
Practice Address - Phone:718-357-1728
Practice Address - Fax:866-923-4356
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY198344207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01840380Medicaid