Provider Demographics
NPI:1144296179
Name:HWANG, RICHARD R (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:RUEYSHIUAN
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4422 3RD AVE
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-860-6150
Mailing Address - Fax:718-860-3617
Practice Address - Street 1:4422 3RD AVE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-860-6150
Practice Address - Fax:718-860-3617
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205026207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02Q611Medicare ID - Type Unspecified
G97640Medicare UPIN