Provider Demographics
NPI:1831358134
Name:WANG, DANNY C (MD, MPH)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:C
Last Name:WANG
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 WYNSUM AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5408
Mailing Address - Country:US
Mailing Address - Phone:562-650-5999
Mailing Address - Fax:717-812-2244
Practice Address - Street 1:2833 WYNSUM AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5408
Practice Address - Country:US
Practice Address - Phone:562-650-5999
Practice Address - Fax:717-812-2244
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2600402085R0202X, 2085R0204X
PAMD4459652085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30120393OtherAMERIHEALTH MERCY - WMG
PA418503OtherUPMC
PA2711042OtherHIGHMARK BLUE SHIELD
MD056654300Medicaid
PA1607763OtherGATEWAY
PA102723210Medicaid
PA102723210Medicaid
PAP01094867Medicare PIN