Healthcare Provider Details

I. General information

NPI: 1114199833
Provider Name (Legal Business Name): ANNE H HUANG-KWOK RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 MIDDLE COUNTRY RD
MIDDLE ISLAND NY
11953
US

IV. Provider business mailing address

1235 MIDDLE COUNTRY RD
MIDDLE ISLAND NY
11953-2515
US

V. Phone/Fax

Practice location:
  • Phone: 631-924-0684
  • Fax: 631-345-3466
Mailing address:
  • Phone: 631-924-0684
  • Fax: 631-345-3466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number049149
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: