Healthcare Provider Details

I. General information

NPI: 1992255590
Provider Name (Legal Business Name): MS. SIH-CHIAO HSU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W111TH STREET APT 3D
NEW YORK NY
10025
US

IV. Provider business mailing address

515 W111TH STREET APT 3D
NEW YORK NY
10025-1919
US

V. Phone/Fax

Practice location:
  • Phone: 631-609-5678
  • Fax:
Mailing address:
  • Phone: 631-609-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: