Provider Demographics
NPI:1093159097
Name:HUANG, MAOCHENG
Entity Type:Individual
Prefix:
First Name:MAOCHENG
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7347 190TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1853
Mailing Address - Country:US
Mailing Address - Phone:646-330-0733
Mailing Address - Fax:
Practice Address - Street 1:7347 190TH ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1853
Practice Address - Country:US
Practice Address - Phone:646-330-0733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-20
Last Update Date:2013-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057862183500000X
TX52504183500000X
NJ28RI03550300183500000X
CTPCT.0012507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist