Healthcare Provider Details

I. General information

NPI: 1710595335
Provider Name (Legal Business Name): AIMEE HUANG AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 01/05/2025
Certification Date: 01/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 61ST ST STE 402
BROOKLYN NY
11220-5163
US

IV. Provider business mailing address

749 61ST ST STE 402
BROOKLYN NY
11220-5163
US

V. Phone/Fax

Practice location:
  • Phone: 718-362-6388
  • Fax: 718-362-6399
Mailing address:
  • Phone: 718-362-6388
  • Fax: 718-362-6399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF309674-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: