Provider Demographics
NPI:1689428286
Name:HUANG, WAN (MDD)
Entity Type:Individual
Prefix:
First Name:WAN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MDD
Other - Prefix:
Other - First Name:BELLE
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:107 SUMMER ST APT 411
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2540
Mailing Address - Country:US
Mailing Address - Phone:484-881-2124
Mailing Address - Fax:
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program