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Contact Information

JIAN WANG, M.D., PH.D.
151 KNOLLCROFT RD
EXTENDED CARE LINE
LYONS, NJ07019
 Phone: 832-766-3990
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JIAN WANG · (Female)

NPI Number 1356402093
Status Active
Credentials M.D., PH.D.
Entity Individual
Enumeration date 12/13/2006
Last updated 09/17/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 25MA08379000
  • TX License # M5568
  • TX Medicaid 186598202
  • TX Medicaid K3204660
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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