Provider Demographics
NPI:1629800081
Name:HUANG, GRACE LI (PHD)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:LI
Last Name:HUANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:140 ADAMS AVE STE B13
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3618
Mailing Address - Country:US
Mailing Address - Phone:631-617-6011
Mailing Address - Fax:631-617-6023
Practice Address - Street 1:140 ADAMS AVE STE B13
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3618
Practice Address - Country:US
Practice Address - Phone:631-617-6011
Practice Address - Fax:631-617-6023
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1386246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic