Healthcare Provider Details

I. General information

NPI: 1770030397
Provider Name (Legal Business Name): CHING MING HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

588 BROADWAY
NEW YORK NY
10012
US

IV. Provider business mailing address

588 BROADWAY
NEW YORK NY
10012-2937
US

V. Phone/Fax

Practice location:
  • Phone: 917-860-9618
  • Fax:
Mailing address:
  • Phone: 917-860-9618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: