Healthcare Provider Details

I. General information

NPI: 1821410499
Provider Name (Legal Business Name): SHAOHUA HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8268 164TH ST
JAMAICA NY
11432-1121
US

IV. Provider business mailing address

7901 BROADWAY # D101
ELMHURST NY
11373-1329
US

V. Phone/Fax

Practice location:
  • Phone: 718-883-3225
  • Fax:
Mailing address:
  • Phone: 718-334-1921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number317639
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: