Provider Demographics
NPI:1306116934
Name:WANG, JENNIFER (DO)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WANG
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Gender:F
Credentials:DO
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Mailing Address - Street 1:ONE GUSTAVE LEVY PLACE
Mailing Address - Street 2:1264
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-8867
Mailing Address - Fax:212-860-3669
Practice Address - Street 1:ONE GUSTAVE LEVY PLACE, DEPARTMENT OF SURGERY
Practice Address - Street 2:1264
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-8867
Practice Address - Fax:212-860-3669
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2020-12-04
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Provider Licenses
StateLicense IDTaxonomies
NY275058207RC0200X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine