Healthcare Provider Details

I. General information

NPI: 1659566628
Provider Name (Legal Business Name): MICHAEL S. HUANG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3084 STATE RD. ROUTE 27 SUITE 5
KENDALL PARK NJ
08824
US

IV. Provider business mailing address

10 GALWAY RD
SKILLMAN NJ
08558-1731
US

V. Phone/Fax

Practice location:
  • Phone: 800-247-0309
  • Fax:
Mailing address:
  • Phone: 856-816-2375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB08203100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number25MB08203100
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MB08203100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: