Healthcare Provider Details

I. General information

NPI: 1811509250
Provider Name (Legal Business Name): STEVEN HUANG OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 NEW RD
LINWOOD NJ
08221-1039
US

IV. Provider business mailing address

6 SAMARA CIR
NORTHFIELD NJ
08225-1081
US

V. Phone/Fax

Practice location:
  • Phone: 609-927-2020
  • Fax:
Mailing address:
  • Phone: 609-442-7710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00698300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: