Healthcare Provider Details

I. General information

NPI: 1952952434
Provider Name (Legal Business Name): JENNY HUA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7035 150TH ST
FLUSHING NY
11367-2024
US

IV. Provider business mailing address

7035 150TH ST
FLUSHING NY
11367-2024
US

V. Phone/Fax

Practice location:
  • Phone: 718-263-4004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number029122
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: