Provider Demographics
NPI:1811475627
Name:WANG, JULIETTE CEDAR (APN)
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:CEDAR
Last Name:WANG
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:546 RICHARD PL
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1703
Mailing Address - Country:US
Mailing Address - Phone:973-933-6154
Mailing Address - Fax:201-379-5779
Practice Address - Street 1:718 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4245
Practice Address - Country:US
Practice Address - Phone:201-833-3463
Practice Address - Fax:201-379-5779
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00567200363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology