MEDICARE: DR. SHUNQI HUANG OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	5520	MA
2	152W00000X	Optometrist	TUV008673	NY

General Provider Information

NPI Number	:	1023533957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHUNQI HUANG OD

Provider Business Mailing Address
First Line	:	6713 10TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6713 10TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5808
Country	:	US
Telephone Number	:	781-879-5079
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	04/08/2022

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