Healthcare Provider Details

I. General information

NPI: 1316413230
Provider Name (Legal Business Name): ZHENG ZHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 HIGH RIDGE RD
STAMFORD CT
06905-1214
US

IV. Provider business mailing address

1011 WASHINGTON BLVD UNIT 509
STAMFORD CT
06901-2223
US

V. Phone/Fax

Practice location:
  • Phone: 203-322-7669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0014653
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: