MEDICARE: MR. KEVIN SZU-WEI HUANG RPT

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	225100000X	Physical Therapist	014821	NY
2	225100000X	Physical Therapist	6845	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841346988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEVIN SZU-WEI HUANG RPT

Provider Business Mailing Address
First Line	:	22205 GRAND CENTRAL PKWY
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1205
Country	:	US
Telephone Number	:	718-217-7141
Fax Number	:	718-217-7141

Provider Business Practice Location Address
First Line	:	22205 GRAND CENTRAL PKWY
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1205
Country	:	US
Telephone Number	:	917-679-0542
Fax Number	:	718-217-7141

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	09/30/2021

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