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General NPI Number Information
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NPI Number | 1861801177
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Entity Type | Individual
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Provider Name | MARISSA HUANG O.D
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Gender | Female
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1209 LEXINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10028-1404
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Country | US
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Telephone | 646-757-2290
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Fax | 646-417-7732
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Provider Business Mailing Address
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Address Line | 333 E 79TH ST APT 15W
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City | NEW YORK
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State | NY
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Zip | 10075-0960
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Country | US
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Telephone | 415-246-2376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 15444
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV008153-1
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License Number State | NY
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