Healthcare Provider Details

I. General information

NPI: 1023213725
Provider Name (Legal Business Name): MINGQIAN HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NICOLLS ROAD AND HEALTH SCIENCES HSC LEVEL 4 ROOM 120
STONY BROOK NY
11794-8460
US

IV. Provider business mailing address

22 W 26TH ST APT 2A
NEW YORK NY
10010-2023
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-7955
  • Fax:
Mailing address:
  • Phone: 617-395-8865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number246541
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: