Provider Demographics
NPI:1982115200
Name:HUANG, JEN-YEN
Entity Type:Individual
Prefix:MS
First Name:JEN-YEN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 CONGRESS PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4098
Mailing Address - Country:US
Mailing Address - Phone:937-439-9330
Mailing Address - Fax:937-439-9337
Practice Address - Street 1:925 CONGRESS PARK DR STE B
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4098
Practice Address - Country:US
Practice Address - Phone:937-439-9330
Practice Address - Fax:937-439-9337
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000313171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist