Provider Demographics
NPI:1699446047
Name:WANG, WANLING (FNP, MS)
Entity type:Individual
Prefix:
First Name:WANLING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:FNP, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15917 POWELLS COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1335
Mailing Address - Country:US
Mailing Address - Phone:347-387-0667
Mailing Address - Fax:
Practice Address - Street 1:15917 POWELLS COVE BLVD
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1335
Practice Address - Country:US
Practice Address - Phone:347-387-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2024-02-07
Deactivation Date:2024-02-01
Deactivation Code:
Reactivation Date:2024-02-06
Provider Licenses
StateLicense IDTaxonomies
NY353478363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily