Healthcare Provider Details

I. General information

NPI: 1821497769
Provider Name (Legal Business Name): IRENE HUANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2014
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 3RD AVE
NEW YORK NY
10128-3105
US

IV. Provider business mailing address

1550 3RD AVE
NEW YORK NY
10128-3105
US

V. Phone/Fax

Practice location:
  • Phone: 646-672-1439
  • Fax: 646-672-1445
Mailing address:
  • Phone: 646-672-1439
  • Fax: 646-672-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number059699
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: