Provider Demographics
NPI:1932484565
Name:WANG, HUIYI (LAC)
Entity Type:Individual
Prefix:MS
First Name:HUIYI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 N 10TH ST
Mailing Address - Street 2:1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3005
Mailing Address - Country:US
Mailing Address - Phone:267-456-4515
Mailing Address - Fax:
Practice Address - Street 1:46 N 10TH ST
Practice Address - Street 2:1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3005
Practice Address - Country:US
Practice Address - Phone:267-257-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00085200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist