Healthcare Provider Details

I. General information

NPI: 1629650205
Provider Name (Legal Business Name): ELISABETH HUH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 09/25/2022
Certification Date: 09/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 COLUMBUS CIR FL 6
NEW YORK NY
10019-1412
US

IV. Provider business mailing address

320 E 46TH ST APT 6A
NEW YORK NY
10017-3072
US

V. Phone/Fax

Practice location:
  • Phone: 212-326-8437
  • Fax:
Mailing address:
  • Phone: 917-940-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06845800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number116397
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: