Provider Demographics
NPI:1316103575
Name:WANG, FANG YIN (RPA-C)
Entity type:Individual
Prefix:MISS
First Name:FANG YIN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13259 41ST RD
Mailing Address - Street 2:SUITE 1A & 1B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4257
Mailing Address - Country:US
Mailing Address - Phone:718-358-3535
Mailing Address - Fax:718-358-2072
Practice Address - Street 1:13259 41ST RD
Practice Address - Street 2:SUITE 1A & 1B
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4257
Practice Address - Country:US
Practice Address - Phone:718-358-3535
Practice Address - Fax:718-358-2072
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY012805363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical