Healthcare Provider Details

I. General information

NPI: 1740839992
Provider Name (Legal Business Name): PATERSON DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11912 KANIS RD STE F4
LITTLE ROCK AR
72211-3771
US

IV. Provider business mailing address

PO BOX 86
JERICHO NY
11753-0086
US

V. Phone/Fax

Practice location:
  • Phone: 501-231-0305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FENGJUAN ZHANG
Title or Position: DIRECTOR
Credential: MD
Phone: 501-231-0305