Provider Demographics
NPI:1659917037
Name:WANG, LING (LAC)
Entity Type:Individual
Prefix:MR
First Name:LING
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TERRACE CIR APT 1F
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4119
Mailing Address - Country:US
Mailing Address - Phone:347-925-9848
Mailing Address - Fax:
Practice Address - Street 1:2 HILLSIDE AVE STE E
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2308
Practice Address - Country:US
Practice Address - Phone:516-614-9296
Practice Address - Fax:718-539-6471
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-21
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
006640171100000X
NY006640171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty