Healthcare Provider Details

I. General information

NPI: 1306113113
Provider Name (Legal Business Name): HAO HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14710 45TH AVE
FLUSHING NY
11355-1708
US

IV. Provider business mailing address

10838 47TH AVE
CORONA NY
11368-2931
US

V. Phone/Fax

Practice location:
  • Phone: 718-460-7777
  • Fax: 718-460-8778
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number055962-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: