Provider Demographics
NPI:1306263819
Name:WANG, BINGYAN (DO)
Entity type:Individual
Prefix:DR
First Name:BINGYAN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 BRIDGETON PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2616
Mailing Address - Country:US
Mailing Address - Phone:856-507-2783
Mailing Address - Fax:856-221-4138
Practice Address - Street 1:3 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-2509
Practice Address - Country:US
Practice Address - Phone:856-641-6272
Practice Address - Fax:856-327-6588
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA77459207R00000X
ALDO.2942207R00000X
NJ25MB12153000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine