MEDICARE: ZHENGZHUAN SHI MD

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	207V00000X	Obstetrics & Gynecology Physician	255139	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A400081699	OTHER	NY	MEDICARE PROVIDER TRANSACTION ACCESS NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477889764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZHENGZHUAN SHI MD

Provider Business Mailing Address
First Line	:	749 61ST ST
Second Line	:	STE 302
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4211
Country	:	US
Telephone Number	:	718-676-9398
Fax Number	:	718-676-9397

Provider Business Practice Location Address
First Line	:	749 61ST ST
Second Line	:	STE 302
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4211
Country	:	US
Telephone Number	:	718-676-9398
Fax Number	:	718-676-9397

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

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	03/29/2019

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Directions to “ ZHENGZHUAN SHI MD” Practice Location

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