Healthcare Provider Details

I. General information

NPI: 1598211468
Provider Name (Legal Business Name): DR. HUAN ZHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 LONG HILL RD
GROTON CT
06340-4166
US

IV. Provider business mailing address

79 SCHOOL ST
NEW LONDON CT
06320-4506
US

V. Phone/Fax

Practice location:
  • Phone: 860-448-2225
  • Fax:
Mailing address:
  • Phone: 860-701-0824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number677
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: