Healthcare Provider Details

I. General information

NPI: 1962456087
Provider Name (Legal Business Name): CYNTHIA P HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 03/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 ROYALTON RD SUITE 203
BRECKSVILLE OH
44141-2478
US

IV. Provider business mailing address

842 CORPORATE WAY SUITE850
WESTLAKE OH
44145-1537
US

V. Phone/Fax

Practice location:
  • Phone: 440-526-5101
  • Fax: 440-526-8582
Mailing address:
  • Phone: 440-871-4700
  • Fax: 440-871-4702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number60548
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: