Provider Demographics
NPI:1902861370
Name:HUANG, THERESA M (PA)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:M
Last Name:HUANG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:M
Other - Last Name:SATINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:141 ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825
Mailing Address - Country:US
Mailing Address - Phone:603-664-0100
Mailing Address - Fax:603-664-5769
Practice Address - Street 1:141 ROUTE 125
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825
Practice Address - Country:US
Practice Address - Phone:603-664-0100
Practice Address - Fax:603-664-5769
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003511L363AS0400X
NH0688363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P61735Medicare UPIN
PAP61735Medicare UPIN