Provider Demographics
NPI:1558608752
Name:HUO, YAN (LAC)
Entity Type:Individual
Prefix:MRS
First Name:YAN
Middle Name:
Last Name:HUO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HONEYCOMB LN
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1005
Mailing Address - Country:US
Mailing Address - Phone:203-903-0471
Mailing Address - Fax:203-903-0471
Practice Address - Street 1:5 HONEYCOMB LN
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1005
Practice Address - Country:US
Practice Address - Phone:203-903-0471
Practice Address - Fax:203-903-0471
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000569171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist