Provider Demographics
NPI:1952846347
Name:WANG, ZIXIAO
Entity Type:Individual
Prefix:
First Name:ZIXIAO
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SUMMER ST
Mailing Address - Street 2:APT 501
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3926
Mailing Address - Country:US
Mailing Address - Phone:617-543-9100
Mailing Address - Fax:
Practice Address - Street 1:10 SUMMER ST
Practice Address - Street 2:APT 501
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-3926
Practice Address - Country:US
Practice Address - Phone:617-543-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic