Healthcare Provider Details

I. General information

NPI: 1831417575
Provider Name (Legal Business Name): HAIYIN HUA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6820 BAY PKWY
BROOKLYN NY
11204-5524
US

IV. Provider business mailing address

1540 72ND ST
BROOKLYN NY
11228-2110
US

V. Phone/Fax

Practice location:
  • Phone: 718-489-9118
  • Fax: 718-232-1845
Mailing address:
  • Phone: 516-906-0998
  • Fax: 718-232-1904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number273216
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: