Provider Demographics
NPI:1881776532
Name:WANG, YUNXIA (LAC)
Entity type:Individual
Prefix:
First Name:YUNXIA
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 WAINWRIGHT AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5843
Mailing Address - Country:US
Mailing Address - Phone:914-299-9663
Mailing Address - Fax:718-294-6060
Practice Address - Street 1:1963 GRAND CONCOURSE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4929
Practice Address - Country:US
Practice Address - Phone:718-294-5000
Practice Address - Fax:718-294-6060
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001696-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001696-1OtherLICENSE