Provider Demographics
NPI:1689644502
Name:CHEN-YEN WANG, N.P. INC.
Entity Type:Organization
Organization Name:CHEN-YEN WANG, N.P. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHEN YEN
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:808-550-5868
Mailing Address - Street 1:1702 KEWALO ST
Mailing Address - Street 2:APT 1103
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3034
Mailing Address - Country:US
Mailing Address - Phone:808-538-8792
Mailing Address - Fax:808-550-5684
Practice Address - Street 1:100 N BERETANIA ST
Practice Address - Street 2:SUITE 214
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4712
Practice Address - Country:US
Practice Address - Phone:808-550-5686
Practice Address - Fax:808-550-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-197363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52519901Medicaid
HI54827Medicare ID - Type Unspecified