Provider Demographics
NPI:1861591984
Name:WANG-EPSTEIN, CHRISTINA CONGXIAO (MD, PHD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:CONGXIAO
Last Name:WANG-EPSTEIN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 VERONICA AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5002
Mailing Address - Country:US
Mailing Address - Phone:732-828-0002
Mailing Address - Fax:732-828-0153
Practice Address - Street 1:75 VERONICA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5002
Practice Address - Country:US
Practice Address - Phone:732-828-0002
Practice Address - Fax:732-828-0153
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07954700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ109351M26OtherMEDICARE ID
NJI71210Medicare UPIN