Healthcare Provider Details

I. General information

NPI: 1417359571
Provider Name (Legal Business Name): FAWEI HUANG PHARM. D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2014
Last Update Date: 09/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CANAL ST # 212
NEW YORK NY
10013-4155
US

IV. Provider business mailing address

210 CANAL ST # 212
NEW YORK NY
10013-4155
US

V. Phone/Fax

Practice location:
  • Phone: 212-748-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI058753-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: