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General NPI Number Information
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NPI Number | 1124448576
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Entity Type | Organization
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Legal Business Name | HAIOU DUAN MEDICAL P.C.
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 5314 7TH AVE, 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-2599
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Country | US
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Telephone | 347-689-9112
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Fax | 347-689-2703
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Provider Business Mailing Address
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Address Line | 7101 SHORE RD APT 5C
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City | BROOKLYN
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State | NY
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Zip | 11209-1815
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Country | US
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Telephone | 347-689-9112
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Fax | 347-689-2703
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | HAIOU DUAN
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Credential |
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Telephone | 347-689-9112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 262130
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License Number State | NY
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