Healthcare Provider Details

I. General information

NPI: 1649781410
Provider Name (Legal Business Name): LIJUAN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W 32ND ST FL 8
NEW YORK NY
10001-3212
US

IV. Provider business mailing address

116 W 32ND ST FL 8
NEW YORK NY
10001-3212
US

V. Phone/Fax

Practice location:
  • Phone: 866-551-9700
  • Fax: 646-224-8779
Mailing address:
  • Phone: 866-551-9700
  • Fax: 646-224-8779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number708855
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: