Healthcare Provider Details
I. General information
NPI: 1740200096
Provider Name (Legal Business Name): ROBERT D HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/20/2006
Last Update Date: 07/20/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
485 ROUTE 1 S BLDG B, SUITE 350
ISELIN NJ
08830-3009
US
IV. Provider business mailing address
660 WHITE PLAINS RD STE 400
TARRYTOWN NY
10591-5107
US
V. Phone/Fax
- Phone: 732-549-3934
- Fax: 732-549-7250
- Phone: 914-333-5801
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 25MA05143000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: