Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | F381218-1 | NY |
NPI | 1023186194 |
---|---|
Provider Name | Ms. Mary Yajen Huang |
First Address | New Hyde Park, NY 11042 |
Second Address | New Hyde Park, NY 11042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 30/09/2015 |