Basic Information
| Provider Information | |||||||||
| NPI: | 1649690751 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUANG | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | TED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 FENWOOD RD FL BTM4 | ||||||||
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| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177326600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
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| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177326600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2014 | ||||||||
| LastUpdateDate: | 10/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 35.141728 | OH | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 278575 | MA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.