Provider Demographics
NPI:1265972723
Name:HUA, HOANG
Entity type:Individual
Prefix:
First Name:HOANG
Middle Name:
Last Name:HUA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOANGNHU
Other - Middle Name:THI
Other - Last Name:HUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2209 GENESEE ST.
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5930
Mailing Address - Country:US
Mailing Address - Phone:315-801-4238
Mailing Address - Fax:315-801-8391
Practice Address - Street 1:120 HOBART ST
Practice Address - Street 2:RESIDENCY PROGRAM
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4308
Practice Address - Country:US
Practice Address - Phone:315-801-1149
Practice Address - Fax:315-801-3565
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306992207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine