Provider Demographics
NPI:1710931423
Name:HUANG, CAROL L (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136-20 38TH AVENUE
Mailing Address - Street 2:SUITE 7I
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-886-7546
Mailing Address - Fax:718-886-7586
Practice Address - Street 1:13620 38TH AVE STE 7I
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4232
Practice Address - Country:US
Practice Address - Phone:718-886-7546
Practice Address - Fax:718-886-7586
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224831207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH70435Medicare UPIN
NY06608GMedicare PIN