Healthcare Provider Details

I. General information

NPI: 1780980649
Provider Name (Legal Business Name): CINDY YI-SHAN HUANG PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CINDY YI-SHAN HUANG PHD

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 W 120TH ST
NEW YORK NY
10027
US

IV. Provider business mailing address

106 MORNINGSIDE DR APT 72
NEW YORK NY
10027-6027
US

V. Phone/Fax

Practice location:
  • Phone: 212-678-8118
  • Fax:
Mailing address:
  • Phone: 212-678-8118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number022752
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: