Provider Demographics
NPI:1689693129
Name:WANG, HAI-PO (MD)
Entity Type:Individual
Prefix:DR
First Name:HAI-PO
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 1:1069 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5512
Mailing Address - Country:US
Mailing Address - Phone:718-680-3888
Mailing Address - Fax:718-680-1630
Practice Address - Street 1:1069 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5512
Practice Address - Country:US
Practice Address - Phone:718-680-3888
Practice Address - Fax:718-680-1630
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179212207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01248080Medicaid
NYF35309Medicare UPIN
NY23F721Medicare PIN