Provider Demographics
NPI:1710595335
Name:HUANG, AIMEE (AGNP-C)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 61ST ST STE 402
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5163
Mailing Address - Country:US
Mailing Address - Phone:718-362-6388
Mailing Address - Fax:718-362-6399
Practice Address - Street 1:96 BAY 10TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3702
Practice Address - Country:US
Practice Address - Phone:917-714-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF309674-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health