Provider Demographics
NPI:1811908841
Name:WANG, LYNN (MD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 661 LANKENAU MOB EAST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-649-8085
Mailing Address - Fax:610-649-8984
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 661 LANKENAU MOB EAST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-649-8085
Practice Address - Fax:610-649-8984
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072115L207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H64572Medicare UPIN
PA096244HK1Medicare PIN
H64572Medicare UPIN