Provider Demographics
NPI:1740319227
Name:JOSEPHINE HUANG MD, PLLC
Entity type:Organization
Organization Name:JOSEPHINE HUANG MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:Z
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-226-1211
Mailing Address - Street 1:139 CENTRE ST STE 615
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4556
Mailing Address - Country:US
Mailing Address - Phone:212-226-1211
Mailing Address - Fax:212-226-7462
Practice Address - Street 1:139 CENTRE ST STE 615
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4556
Practice Address - Country:US
Practice Address - Phone:212-226-1211
Practice Address - Fax:212-226-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2216812081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02172269Medicaid
NY03037905Medicaid
NYWPP401Medicare PIN