Provider Demographics
NPI:1760412415
Name:WANG, WENDY (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MRS
Other - First Name:YAQUIN
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:6735 HARBISON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149
Mailing Address - Country:US
Mailing Address - Phone:215-725-2000
Mailing Address - Fax:215-725-8655
Practice Address - Street 1:6735 HARBISON AVE
Practice Address - Street 2:OXFORD REHABILITATION CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149
Practice Address - Country:US
Practice Address - Phone:215-725-2000
Practice Address - Fax:215-725-8655
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015777225100000X
PAAK000498L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1470722000OtherHIGHMARK BS
PAAK000498LOtherACCUPUNTURE
P00174497OtherRR MEDICARE
PA060964QWWMedicare PIN