Provider Demographics
NPI:1568448702
Name:WANG, RONG (M)
Entity Type:Individual
Prefix:
First Name:RONG
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-772-8208
Mailing Address - Fax:603-418-0784
Practice Address - Street 1:3 ALUMNI DR STE 202
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2123
Practice Address - Country:US
Practice Address - Phone:603-772-8208
Practice Address - Fax:603-418-0784
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA523231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076714Medicaid
NH04726401Medicare PIN