Healthcare Provider Details

I. General information

NPI: 1073957411
Provider Name (Legal Business Name): SUNNA HUH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUNNA CHRISTINE HUH

II. Dates (important events)

Enumeration Date: 04/27/2013
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E BROADWAY 13TH FLOOR
NEW YORK NY
10038-1013
US

IV. Provider business mailing address

11 E BROADWAY 13TH FLOOR
NEW YORK NY
10038-1013
US

V. Phone/Fax

Practice location:
  • Phone: 212-227-3088
  • Fax:
Mailing address:
  • Phone: 631-371-1750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number057490-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: