MEDICARE: MRS. HEATHER JEAN HUANG LCSW

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	1041C0700X	Clinical Social Worker	73-074176	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	73-074176	OTHER	NY	LCSW

General Provider Information

NPI Number	:	1346443108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER JEAN HUANG LCSW

Provider Business Mailing Address
First Line	:	15517 SANFORD AVE APT 3F
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-1157
Country	:	US
Telephone Number	:	718-353-7633
Fax Number	:

Provider Business Practice Location Address
First Line	:	4119 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3007
Country	:	US
Telephone Number	:	718-652-0227
Fax Number	:

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	07/08/2007

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