Healthcare Provider Details

I. General information

NPI: 1710314745
Provider Name (Legal Business Name): YANHUA HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3907 PRINCE ST
FLUSHING NY
11354-5357
US

IV. Provider business mailing address

15010 61ST RD
FLUSHING NY
11367-1208
US

V. Phone/Fax

Practice location:
  • Phone: 171-888-8959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number058546
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: