Provider Demographics
NPI:1619042504
Name:HUANG, CHIEN-JEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIEN-JEN
Middle Name:
Last Name:HUANG
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 1:2 MOTT ST
Mailing Address - Street 2:STE 204
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5003
Mailing Address - Country:US
Mailing Address - Phone:212-227-4505
Mailing Address - Fax:212-227-4598
Practice Address - Street 1:2 MOTT ST
Practice Address - Street 2:STE 204
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5003
Practice Address - Country:US
Practice Address - Phone:212-227-4505
Practice Address - Fax:212-227-4598
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117524207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00-218020Medicaid
NY295031Medicare ID - Type Unspecified