Provider Demographics
NPI:1578640645
Name:WANG, LIMENG (MD,)
Entity Type:Individual
Prefix:
First Name:LIMENG
Middle Name:
Last Name:WANG
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 1:820 2ND AVE RM 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4530
Mailing Address - Country:US
Mailing Address - Phone:212-867-6681
Mailing Address - Fax:347-332-1651
Practice Address - Street 1:820 2ND AVE RM 6A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4530
Practice Address - Country:US
Practice Address - Phone:212-867-6681
Practice Address - Fax:347-332-1651
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234541208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02625583Medicaid
NY02625583Medicaid
NY65452TW541Medicare UPIN