Provider Demographics
NPI:1396999074
Name:HUANG, JI Y
Entity type:Individual
Prefix:
First Name:JI
Middle Name:Y
Last Name:HUANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 UNION AVE
Mailing Address - Street 2:ROOM 201
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1200
Mailing Address - Country:US
Mailing Address - Phone:201-615-1285
Mailing Address - Fax:
Practice Address - Street 1:19 UNION AVE
Practice Address - Street 2:ROOM 201
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1200
Practice Address - Country:US
Practice Address - Phone:201-615-1285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-08
Last Update Date:2008-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00145700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist