Provider Demographics
NPI:1447887294
Name:HUANG, ALISEN (MD)
Entity type:Individual
Prefix:
First Name:ALISEN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 PROSPECT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-7127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:646-793-9815
Practice Address - Street 1:450 CLARKSON AVE # 46
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:182-701-2297
Practice Address - Fax:646-793-9815
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY321077207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology