Provider Demographics
NPI:1285698597
Name:FANG, HUI ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:HUI
Middle Name:ELIZABETH
Last Name:FANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:FANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:160 THIRD AVENUE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2545
Mailing Address - Country:US
Mailing Address - Phone:212-674-8327
Mailing Address - Fax:212-505-0719
Practice Address - Street 1:160 THIRD AVENUE
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2545
Practice Address - Country:US
Practice Address - Phone:212-674-8327
Practice Address - Fax:212-505-0719
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208011207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02209869Medicaid
H13428Medicare UPIN
NY402B32Medicare ID - Type Unspecified
NYWFC601Medicare ID - Type UnspecifiedGROUP