Healthcare Provider Details

I. General information

NPI: 1871392944
Provider Name (Legal Business Name): XIAOXUE HUANG
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 192ND ST APT 513
FRESH MEADOWS NY
11365-3778
US

IV. Provider business mailing address

6700 192ND ST APT 513
FRESH MEADOWS NY
11365-3778
US

V. Phone/Fax

Practice location:
  • Phone: 347-654-3599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number072535
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: