Healthcare Provider Details

I. General information

NPI: 1508498916
Provider Name (Legal Business Name): HUY HUYNH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 KNICKERBOCKER AVE
BROOKLYN NY
11237-8055
US

IV. Provider business mailing address

366 KNICKERBOCKER AVE
BROOKLYN NY
11237-8055
US

V. Phone/Fax

Practice location:
  • Phone: 646-604-8160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9121820
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number024431
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: