Healthcare Provider Details

I. General information

NPI: 1962766147
Provider Name (Legal Business Name): WEI-CHUN HUA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIVI HUA PSY.D.

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 2ND AVE
NEW YORK NY
10003-2704
US

IV. Provider business mailing address

3088 36TH ST #2F
ASTORIA NY
11103-4750
US

V. Phone/Fax

Practice location:
  • Phone: 212-683-8905
  • Fax: 212-683-8906
Mailing address:
  • Phone: 347-287-5958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1352294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: