Healthcare Provider Details

I. General information

NPI: 1033827829
Provider Name (Legal Business Name): ZIANG ZHU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 GOLD STAR HWY STE 302
GROTON CT
06340-6703
US

IV. Provider business mailing address

47 N MAIN ST
WEST HARTFORD CT
06107-1926
US

V. Phone/Fax

Practice location:
  • Phone: 860-446-8254
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13800
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: