1912969452 NPI number — DR. LI HUANG

Table of content: DR. LI HUANG (NPI 1912969452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912969452 NPI number — DR. LI HUANG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUANG
Provider First Name:
LI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912969452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30701 LORAIN RD STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH OLMSTED
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44070-6325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-274-5000
Provider Business Mailing Address Fax Number:
440-716-8608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 E MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44304-1619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-375-3786
Provider Business Practice Location Address Fax Number:
330-375-4874
Provider Enumeration Date:
04/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZH0000X , with the licence number:  35-087501 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0102X , with the licence number: 35-087501 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2640628 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000195108 . This is a "UNISON HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".