Mimi Wang, MA, RD, C DN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

386601 Issued in NY

Practice address

800 Poly PL
Brooklyn, NY 11209-7104

Phone

(718) 442-7303

NPI assigned

Feb 5, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1508044215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 RAVENHURST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102631",
            "telephone_number": "718-442-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-442-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MIMI",
        "name_prefix": "Mrs.",
        "credential": "MA, RD, C DN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "386601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lili Wang
• Linda Wang, DDS
• Lita Wang
• Luling Wang
• Maureen Zi Wang, M.D.
• Nick Wang, MD
• Norman Wang, PHARM D.
• Pamela Wang, CCC-SLP
• Pan Pan Wang
• Pei Yuan Wang

• Registered Dietitian in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.