Healthcare Provider Details

I. General information

NPI: 1073805479
Provider Name (Legal Business Name): KAI HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE NYU LANGONE MEDICAL CENTER
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

408 E 92ND ST APT. 4E
NEW YORK NY
10128-6811
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5506
  • Fax:
Mailing address:
  • Phone: 703-477-7237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA10368700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number270609
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: