Healthcare Provider Details

I. General information

NPI: 1285263160
Provider Name (Legal Business Name): PATRICK JIA HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVENUE, DEPT. OF ORTHOPAEDICS
ALBANY NY
12208-3412
US

IV. Provider business mailing address

47 NEW SCOTLAND AVENUE, DEPT. OF ORTHOPAEDICS
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 518-489-2666
  • Fax: 518-489-5933
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: