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General NPI Number Information
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NPI Number | 1700655875
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Entity Type | Organization
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Legal Business Name | HUAQIAO INC
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Dates
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Enumeration Date | 12/29/2023
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 4177 KISSENA BLVD
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City | FLUSHING
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State | NY
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Zip | 11355-3155
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Country | US
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Telephone | 718-775-8618
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Fax |
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Provider Business Mailing Address
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Address Line | 4177 KISSENA BLVD
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City | FLUSHING
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State | NY
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Zip | 11355-3155
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Country | US
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Telephone | 718-775-8618
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MARK KOSTIN
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Credential | MD
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Telephone | 718-755-8618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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