Jack Jay Huang
Student in an Organized Health Care Education/Training Program in Boston, MA. Individual provider (NPI-1).
NPI number1104576537
StatusActive
Last updated in NPPESMar 28, 2022
Details
- NPI
- 1104576537
- Entity type
- Individual (NPI-1)
- Name
- Jack Jay Huang
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2022
- Certification date
- Mar 28, 2022
- Last updated
- Mar 28, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PSYCHIATRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
60 Fenwood RdBoston, MA 02115-6128
Phone 617-732-5056
Mailing address
60 Fenwood RdBoston, MA 02115-6128
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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