MEDICARE: MR. JIAN ZHAO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	2344731	NY
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	2344731	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	10095329	OTHER	NY	CDPHP
3	4141638	OTHER	NY	MVP

General Provider Information

NPI Number	:	1427164219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JIAN ZHAO M.D.

Provider Business Mailing Address
First Line	:	178 CLIZBE AVE
Second Line	:
City	:	AMSTERDAM
State	:	NY
Zip	:	12010-7520
Country	:	US
Telephone Number	:	518-843-8745
Fax Number	:	518-842-9633

Provider Business Practice Location Address
First Line	:	178 CLIZBE AVE
Second Line	:
City	:	AMSTERDAM
State	:	NY
Zip	:	12010-7520
Country	:	US
Telephone Number	:	518-843-8745
Fax Number	:	518-842-9633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	03/29/2011

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Directions to “ MR. JIAN ZHAO M.D.” Practice Location

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