Healthcare Provider Details
I. General information
NPI: 1184156051
Provider Name (Legal Business Name): YU-YUN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/30/2017
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
575 ROUTE 28 STE 2205
RARITAN NJ
08869-1363
US
IV. Provider business mailing address
575 ROUTE 28 STE 2205
RARITAN NJ
08869-1363
US
V. Phone/Fax
- Phone: 908-725-5530
- Fax: 908-253-6559
- Phone: 89-725-5530
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 25MA12349700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: