Provider Demographics
NPI:1356472492
Name:NY OTOLARYNGOLOGY PLLC
Entity Type:Organization
Organization Name:NY OTOLARYNGOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-670-0006
Mailing Address - Street 1:13620 38TH AVE
Mailing Address - Street 2:SUITE 7J
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4233
Mailing Address - Country:US
Mailing Address - Phone:718-670-0006
Mailing Address - Fax:718-701-5883
Practice Address - Street 1:13620 38TH AVE
Practice Address - Street 2:SUITE 7J
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-670-0006
Practice Address - Fax:718-701-5883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192242174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty