Healthcare Provider Details

I. General information

NPI: 1922512250
Provider Name (Legal Business Name): HUA FAMILY MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2017
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: 718-232-1904
Mailing address:
  • Phone: 718-489-9118
  • Fax: 718-232-1904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HAIYIN HUA
Title or Position: MD
Credential: MD
Phone: 516-906-0998