Healthcare Provider Details

I. General information

NPI: 1295957686
Provider Name (Legal Business Name): HSUN-CHUN HSU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13336 41ST RD #1G
FLUSHING NY
11355-3666
US

IV. Provider business mailing address

14205 ROOSEVELT AVE APT#407
FLUSHING NY
11354-6045
US

V. Phone/Fax

Practice location:
  • Phone: 718-321-8886
  • Fax:
Mailing address:
  • Phone: 718-463-5287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number051546
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: