Provider Demographics
NPI:1043557739
Name:HUANG, JENNIFER (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 E FORDHAM RD
Mailing Address - Street 2:O'HARE HALL- UNIVERSITY HEALTH SERVICES
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5149
Mailing Address - Country:US
Mailing Address - Phone:718-817-4160
Mailing Address - Fax:
Practice Address - Street 1:441 E FORDHAM RD
Practice Address - Street 2:O'HARE HALL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5149
Practice Address - Country:US
Practice Address - Phone:718-817-4160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305280-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health