Provider Demographics
NPI:1780780957
Name:WANG, GUANGYI (MD)
Entity type:Individual
Prefix:
First Name:GUANGYI
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 1:7126 164TH ST
Mailing Address - Street 2:#3
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4239
Mailing Address - Country:US
Mailing Address - Phone:718-303-2114
Mailing Address - Fax:
Practice Address - Street 1:9002 QUEENS BLVD.
Practice Address - Street 2:ST. JOHN'S QUEENS HOSPITAL
Practice Address - City:ELMHURST,
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-558-1968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2326522085B0100X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology