Healthcare Provider Details

I. General information

NPI: 1871001339
Provider Name (Legal Business Name): JUSTIN HUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2652 DUNNING DR
YORKTOWN HEIGHTS NY
10598-3803
US

IV. Provider business mailing address

21 BURD ST
NYACK NY
10960-3205
US

V. Phone/Fax

Practice location:
  • Phone: 914-409-6111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: