Healthcare Provider Details

I. General information

NPI: 1548700750
Provider Name (Legal Business Name): MS. SO-MIN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST SUITE B213
PITTSBURGH PA
15213-2536
US

IV. Provider business mailing address

200 LOTHROP ST SUITE B213
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 360-609-9358
  • Fax:
Mailing address:
  • Phone: 360-609-9358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN659200
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: