Provider Demographics
NPI:1235167313
Name:WEI, HUACHEN (MD)
Entity Type:Individual
Prefix:
First Name:HUACHEN
Middle Name:
Last Name:WEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 56TH AVE
Mailing Address - Street 2:1 FL
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4831
Mailing Address - Country:US
Mailing Address - Phone:718-457-0002
Mailing Address - Fax:718-457-9108
Practice Address - Street 1:8701 56TH AVE
Practice Address - Street 2:1 FL
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4831
Practice Address - Country:US
Practice Address - Phone:718-457-0002
Practice Address - Fax:718-457-9108
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215477207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02092368Medicaid
H20016Medicare UPIN
NY02092368Medicaid
NY5393PYMedicare ID - Type Unspecified