Healthcare Provider Details

I. General information

NPI: 1801779103
Provider Name (Legal Business Name): HUANG MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 BARSTOW RD STE 306
GREAT NECK NY
11021-2222
US

IV. Provider business mailing address

29 BARSTOW RD STE 306
GREAT NECK NY
11021-2222
US

V. Phone/Fax

Practice location:
  • Phone: 516-699-3106
  • Fax:
Mailing address:
  • Phone: 516-699-3106
  • Fax: 949-864-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MIAO HUANG
Title or Position: PRESIDENT
Credential: DO
Phone: 516-366-4205