Provider Demographics
NPI:1760469969
Name:HUA, TUAN Q (MD)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:Q
Last Name:HUA
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 1:2431-33 86TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:718-513-6503
Mailing Address - Fax:718-513-6504
Practice Address - Street 1:2431-33 86TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKYLN
Practice Address - State:NY
Practice Address - Zip Code:11214
Practice Address - Country:US
Practice Address - Phone:718-513-6503
Practice Address - Fax:718-513-6504
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93962207RG0300X
NY226755207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02526772Medicaid
NY02526772Medicaid
96743Medicare UPIN