Provider Demographics
NPI:1821792177
Name:WANG, LIANG-YAO
Entity type:Individual
Prefix:DR
First Name:LIANG-YAO
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3164 21ST ST # 1095
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4573
Mailing Address - Country:US
Mailing Address - Phone:929-224-2253
Mailing Address - Fax:
Practice Address - Street 1:3164 21ST ST # 1095
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-4573
Practice Address - Country:US
Practice Address - Phone:929-224-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPPY2568103T00000X
WAPY61043196103TC0700X
NY025691103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist