Provider Demographics
NPI:1962766147
Name:HUA, WEI-CHUN (PSYD)
Entity type:Individual
Prefix:DR
First Name:WEI-CHUN
Middle Name:
Last Name:HUA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:VIVI
Other - Middle Name:
Other - Last Name:HUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:3088 36TH ST
Mailing Address - Street 2:#2F
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4750
Mailing Address - Country:US
Mailing Address - Phone:347-287-5958
Mailing Address - Fax:
Practice Address - Street 1:236 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2704
Practice Address - Country:US
Practice Address - Phone:212-683-8905
Practice Address - Fax:212-683-8906
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1352294103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool