Provider Demographics
NPI:1831417575
Name:HUA, HAIYIN (MD)
Entity type:Individual
Prefix:
First Name:HAIYIN
Middle Name:
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 1:1540 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2110
Mailing Address - Country:US
Mailing Address - Phone:516-906-0998
Mailing Address - Fax:718-232-1904
Practice Address - Street 1:6820 BAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5524
Practice Address - Country:US
Practice Address - Phone:718-489-9118
Practice Address - Fax:718-232-1845
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273216207Q00000X
VA0101255343207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03801094Medicaid