Provider Demographics
NPI:1316087067
Name:HUANG, SU-I DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:SU-I
Middle Name:DANIEL
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:935 NORTHERN BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5316
Mailing Address - Country:US
Mailing Address - Phone:516-482-1400
Mailing Address - Fax:516-466-6575
Practice Address - Street 1:935 NORTHERN BOULEVARD
Practice Address - Street 2:SUITE 103
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:516-482-1400
Practice Address - Fax:516-466-6575
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2014-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY228033208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2406H1Medicare ID - Type Unspecified
NY05805Medicare ID - Type Unspecified
NYH85939Medicare UPIN