Provider Demographics
NPI:1932709821
Name:WANG, SHU-HENG (PNP-AC)
Entity Type:Individual
Prefix:
First Name:SHU-HENG
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:PNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1703
Mailing Address - Country:US
Mailing Address - Phone:657-358-5317
Mailing Address - Fax:
Practice Address - Street 1:7324 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5678
Practice Address - Country:US
Practice Address - Phone:718-837-6188
Practice Address - Fax:212-274-8457
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF383202363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics