Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 258414 | NY |
N | 207ND0900X | Dermatopathologist | 258414-1 | NY |
N | 207NP0225X | Pediatric Dermatologist | 258414 | NY |
N | 207NS0135X | Procedural Dermatology | 258414 | NY |
NPI | 1326270968 |
---|---|
Provider Name | Dr. Stephanie W. Hu |
First Address | Elmhurst, NY 11373-1234 |
Second Address | Flushing, NY 11354-4231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2009 |
Last Update Date | 14/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04009945 | (05) | NY |
G400173736 | MEDICARE PTAN (01) | NY |