Provider Demographics
NPI:1992899256
Name:WANG, JOHN TSIHSIAN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:TSIHSIAN
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 UNION ST STE 3F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5544
Mailing Address - Country:US
Mailing Address - Phone:347-248-6841
Mailing Address - Fax:718-559-0927
Practice Address - Street 1:3808 UNION ST STE 3F
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5544
Practice Address - Country:US
Practice Address - Phone:347-248-6841
Practice Address - Fax:718-559-0927
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234554-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI63839Medicare UPIN
FL264SV1Medicare PIN