Healthcare Provider Details

I. General information

NPI: 1356507461
Provider Name (Legal Business Name): CINDY HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE ATTN: 10E1 (ENDOSCOPY SUITE)
NEW YORK NY
10016-9196
US

IV. Provider business mailing address

300 W 145TH ST APT 3M
NEW YORK NY
10039-3142
US

V. Phone/Fax

Practice location:
  • Phone: 516-983-0583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number249731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: