Organization Active NPI

Queens Crossing Dermatology, PLLC

  • Dermatology Physician
  • Flushing, NY
National Provider Identifier
1033310362
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
224831 Issued in NY
Legal business name
QUEENS CROSSING DERMATOLOGY, PLLC
Practice address
13620 38TH Ave
Suite 7I
Flushing, NY 11354-4233
Phone
(718) 886-7546
Fax
(718) 886-7586
NPI assigned
May 31, 2007
Last updated
Sep 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carol Huang, M.D.NPI 1710931423
Title
Dermatologist
Phone
(718) 886-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 224831 NY Primary

Addresses

Primary practice location

13620 38TH Ave
Suite 7I
Flushing, NY 11354-4233

Mailing address

13620 38TH Ave
Suite 7I
Flushing, NY 11354-4233
Phone (718) 886-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000761 NY Part B Supplier - Clinic/Group Practice 5496714024 Receives reassigned benefits from 6 practitioners
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

13620 38th Ave
Ste 7I
Flushing, NY 11354
Phone (718) 886-7546

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1033310362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13620 38TH AVE",
            "address_2": "SUITE 7I",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544233",
            "telephone_number": "718-886-7546",
            "fax_number": "718-886-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13620 38TH AVE",
            "address_2": "SUITE 7I",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544233",
            "telephone_number": "718-886-7546",
            "fax_number": "718-886-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS CROSSING DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "HUANG",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "718-886-7546",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "224831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.