Healthcare Provider Details

I. General information

NPI: 1912098161
Provider Name (Legal Business Name): MEI-HWA HSU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10404 CORONA AVE
CORONA NY
11368-2924
US

IV. Provider business mailing address

7901 BROADWAY MANAGED CARE, D1-01
ELMHURST NY
11373-1329
US

V. Phone/Fax

Practice location:
  • Phone: 718-334-6100
  • Fax: 718-334-6110
Mailing address:
  • Phone: 718-334-1921
  • Fax: 718-334-3432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number133207
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: