Basic Information
| Provider Information | |||||||||
| NPI: | 1578706032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WANG | ||||||||
| FirstName: | XUAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 80 CROSSWAYS PARK DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117972047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169443882 | ||||||||
| FaxNumber: | 5168832936 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 CROSSWAYS PARK DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117972047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169443882 | ||||||||
| FaxNumber: | 5168832936 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2009 | ||||||||
| LastUpdateDate: | 06/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0101X | MD449818 | PA | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | 25MA09348000 | NJ | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | 265625 | NY | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZD0900X | MD449818 | PA | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZD0900X | 265625 | NY | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZD0900X | 0101255044 | VA | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZD0900X | 25MA09348000 | NJ | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZD0900X | D0078003 | MD | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZD0900X | C1-0010740 | DE | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZP0101X | C1-0010740 | DE | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | 0101255044 | VA | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | D0078003 | MD | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology |
No ID Information.