Healthcare Provider Details

I. General information

NPI: 1366808511
Provider Name (Legal Business Name): YIQUN HUI MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2016
Last Update Date: 01/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 215TH ST 1ST FL
BAYSIDE NY
11361-2976
US

IV. Provider business mailing address

180 S MIDDLE NECK RD 3A
GREAT NECK NY
11021-4643
US

V. Phone/Fax

Practice location:
  • Phone: 718-889-1062
  • Fax: 718-374-6582
Mailing address:
  • Phone: 917-239-4720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number261914
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number261914
License Number StateNY

VIII. Authorized Official

Name: DR. YIQUN HUI
Title or Position: OWNER
Credential: MD, PHD
Phone: 718-889-1062