Healthcare Provider Details

I. General information

NPI: 1851476972
Provider Name (Legal Business Name): HUI-LI HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MMG - GRAND CONCOURSE 2532 GRAND CONCOURSE
BRONX NY
10458
US

IV. Provider business mailing address

26 CORNELL ST
SCARSDALE NY
10583-7608
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-1507
  • Fax:
Mailing address:
  • Phone: 718-960-1507
  • Fax: 718-960-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number157923
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: