Healthcare Provider Details

I. General information

NPI: 1700838166
Provider Name (Legal Business Name): JUN C. HUANG M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 NEW ROAD QUALITY EYE ASSOC.LLC
LINWOOD NJ
08221
US

IV. Provider business mailing address

2020 NEW ROAD
LINWOOD NJ
08221-1039
US

V. Phone/Fax

Practice location:
  • Phone: 609-927-2020
  • Fax: 609-926-7616
Mailing address:
  • Phone: 609-927-2020
  • Fax: 609-926-7616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA06345500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: