CHARLES B. WANG COMMUNITY HEALTH CENTER, INC. (NPI# 1417261298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417261298 |
| Entity Type | Organization |
| Organization Name | CHARLES B. WANG COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
125 Walker St New York NY 10013-4135 |
| Mailing Address |
268 Canal St New York NY 10013-3599 |
| Practice Telephone | 2122268866 |
| Mailing Telephone | 2123796988 |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2010-08-04 |
| Authorized Official Name | JANE T. ENG (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2123796988 |
| Authorized Official Credential | ESQ. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
7002107R | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00356318 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407229651 | Charles B. Wang Community Health Center, Inc. | Clinic/Center | 13739 45th Ave, Flushing, NY 11355-4094 | 2015-11-10 |
| 1780998575 | Charles B. Wang Community Health Center, Inc. | Clinic/Center | 13626 37th Ave, Flushing, NY 11354-6533 | 2010-08-04 |
| 1144203498 | Charles B. Wang Community Health Center, Inc. | Clinic/Center | 268 Canal St, New York, NY 10013-3599 | 2005-11-21 |
| Street Address |
125 WALKER ST |
| City | NEW YORK |
| State | NY |
| Zip Code | 10013-4135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720077506 | Loretta Young Au | Pediatrics | 125 Walker St, New York, NY 10013-4135 | 2005-10-14 |
| 1356872121 | Yiwan Wu | Registered Nurse | 125 Walker St, Charles B Wang Community Center, 2f, New York, NY 10013-4135 | 2017-03-23 |
| 1659821031 | Yuyuan Zheng | Social Worker | 125 Walker St, 2/f, New York, NY 10013-4135 | 2016-10-10 |
| 1053869883 | Josephine Tong | Social Worker | 125 Walker St, 2nd Floor, New York, NY 10013-4135 | 2016-09-21 |
| 1366833808 | Katie Lim | Dentist | 125 Walker St, New York, NY 10013-4135 | 2015-02-05 |
| 1497015556 | Rachel Liao Chan | Registered Nurse | 125 Walker St, 2nd Floor, New York, NY 10013-4135 | 2012-05-23 |
| 1619271640 | Amanda M Wong | Social Worker | 125 Walker St, 2 Nd Floor, New York, NY 10013-4135 | 2011-01-05 |
| 1508176405 | Rebecca Sawyer | Social Worker | 125 Walker St, 2nd Floor, New York, NY 10013-4135 | 2010-10-14 |
| 1336458710 | Shao-ling Hu | Social Worker | 125 Walker St, New York, NY 10013-4135 | 2010-10-01 |
| 1528377900 | Siu Fong Au Yeung | Social Worker | 125 Walker St, 2nd Floor, New York, NY 10013-4135 | 2010-10-01 |
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|---|---|---|---|---|
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| 1285263806 | Dcw Providers, P.a. | Family Medicine | 394 Broadway 3rd Floor, New York, NY 10013 | 2020-04-06 |
| 1083249411 | Phoebe Richman | Social Worker | 121 Ave of The Americas, New York, NY 10013 | 2020-03-05 |
| 1366087868 | Kelsey C Sjolund | Speech-Language Pathologist | Speak Out New York, 100 Reade Street C/o Gymboree, Tribeca, NY 10013 | 2019-11-08 |
| 1720560717 | Julia I Pema Dolma Gutman | Social Worker | 85 Bayard St, Suite 4, New York, NY 10013 | 2018-09-05 |
| 1881187169 | Markus Burrell | Social Worker | 350 Canal St # 574p, New York, NY 10013 | 2018-06-11 |
| 1659879799 | Shui-fong Chong | Acupuncturist | 139 Centre Street, Suite 315, New York, NY 10013 | 2018-01-23 |
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| 1528570397 | Lauren Haythe | Acupuncturist | 481 Broadway, Suite 3, Manhattan, NY 10013 | 2017-11-01 |
| 1235648395 | William L Jim | Occupational Therapist | 139 Centre St Ste 814, New York, NY 10013 | 2017-09-21 |
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| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1588691828 | William F. Ryan Community Health Center Inc | Clinic/Center | 279 E 3rd St, New York, NY 10009 | 2006-06-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.