Provider Demographics
NPI:1104257898
Name:HUANG, SHIH-HUNG NICK
Entity type:Individual
Prefix:
First Name:SHIH-HUNG
Middle Name:NICK
Last Name:HUANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 SOMERVILLE AVE
Mailing Address - Street 2:#3
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3531
Mailing Address - Country:US
Mailing Address - Phone:617-866-7606
Mailing Address - Fax:
Practice Address - Street 1:771 SOMERVILLE AVE # 3
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3531
Practice Address - Country:US
Practice Address - Phone:617-866-7606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health