Provider Demographics
NPI:1144403726
Name:8TH AVENUE MEDICAL OFFICE PLLC
Entity Type:Organization
Organization Name:8TH AVENUE MEDICAL OFFICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HSUIH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-439-6163
Mailing Address - Street 1:775 57TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3505
Mailing Address - Country:US
Mailing Address - Phone:718-439-6163
Mailing Address - Fax:718-439-6815
Practice Address - Street 1:775 57TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3505
Practice Address - Country:US
Practice Address - Phone:718-439-6163
Practice Address - Fax:718-879-6461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205969305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01828413Medicaid
NY01828413Medicaid
NYW31041Medicare PIN