Healthcare Provider Details

I. General information

NPI: 1558643007
Provider Name (Legal Business Name): KUAN-HSIANG GARY HUANG M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 OLD YORK RD BLDG 300
PHILADELPHIA PA
19141-3018
US

IV. Provider business mailing address

504 BARRINGTON ST
HORSHAM PA
19044-1258
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-6950
  • Fax: 215-456-1766
Mailing address:
  • Phone: 267-210-4989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD453192
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: