Healthcare Provider Details

I. General information

NPI: 1245227206
Provider Name (Legal Business Name): PEI-LI HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 STERGIS WAY
DEDHAM MA
02026
US

IV. Provider business mailing address

45 STERGIS WAY
DEDHAM MA
02026-2637
US

V. Phone/Fax

Practice location:
  • Phone: 781-326-2451
  • Fax: 781-329-2684
Mailing address:
  • Phone: 781-326-2451
  • Fax: 781-329-2684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number74368
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: