Provider Demographics
NPI:1619962578
Name:WANG, DANNY (MD)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PROGRESS ST # 37
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1179
Mailing Address - Country:US
Mailing Address - Phone:908-754-9292
Mailing Address - Fax:732-463-6082
Practice Address - Street 1:35 PROGRESS ST # 37
Practice Address - Street 2:SUITE B-2
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1179
Practice Address - Country:US
Practice Address - Phone:908-754-9292
Practice Address - Fax:732-463-6082
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA56209207RC0000X
NJ25MA05620900207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5041708Medicaid
NJE83193Medicare UPIN
NJ668568Medicare PIN