Healthcare Provider Details

I. General information

NPI: 1710711833
Provider Name (Legal Business Name): WILLIAM HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2024
Last Update Date: 08/30/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 QUEENS PLZ N FL 5
LONG ISLAND CITY NY
11101-4172
US

IV. Provider business mailing address

16615 15TH DR
WHITESTONE NY
11357-2936
US

V. Phone/Fax

Practice location:
  • Phone: 718-391-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number787092-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: