Provider Demographics
NPI:1609484583
Name:TANG, HUA (OD)
Entity Type:Individual
Prefix:DR
First Name:HUA
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 AVALON SQ
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2878
Mailing Address - Country:US
Mailing Address - Phone:617-818-8455
Mailing Address - Fax:
Practice Address - Street 1:1726 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1856
Practice Address - Country:US
Practice Address - Phone:516-209-5168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009167152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist