Provider Demographics
NPI:1598194490
Name:HUANG, LUNBAO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LUNBAO
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14075 ASH AVE OFC 2C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2789
Mailing Address - Country:US
Mailing Address - Phone:917-770-8920
Mailing Address - Fax:
Practice Address - Street 1:320 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3102
Practice Address - Country:US
Practice Address - Phone:212-279-2856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist