Shelly Wang, MD
Individual provider Active NPI Internal Medicine Physician · Rochdale, NY
NPI 1497785752 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497785752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 115499 (NY)
- Practice address
- 16959 137TH Ave
Rochdale, NY 11434-4517 - Phone
- (718) 525-5600
- Fax
- (718) 527-0922
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115499 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Qlimg Rochdale Village OB/GYN Office | Internal Medicine | Past | Accepting new patients |
| Queens Long Island Medical Group, P.C. | Internal Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 115499 | NY | Yes |
Addresses
Primary practice location
16959 137TH Ave
Rochdale, NY 11434-4517
Mailing address
1000 Zeckendorf Blvd
Garden City, NY 11530-2133
Phone (516) 542-6880
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01722765 | Medicaid | NY |
Other providers in Rochdale, NY
All providers in Rochdale, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.