Healthcare Provider Details

I. General information

NPI: 1770934887
Provider Name (Legal Business Name): DIANE HUANG OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13976 35TH AVE APT 3E
FLUSHING NY
11354-3534
US

IV. Provider business mailing address

13976 35TH AVE APT 3E
FLUSHING NY
11354-3534
US

V. Phone/Fax

Practice location:
  • Phone: 917-783-3828
  • Fax:
Mailing address:
  • Phone: 917-783-3828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number020535
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: