Healthcare Provider Details

I. General information

NPI: 1093478497
Provider Name (Legal Business Name): DAPHNE ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 WASHINGTON ST
BOSTON MA
02108-5177
US

IV. Provider business mailing address

485 FOLEY ST UNIT 340
SOMERVILLE MA
02145-1269
US

V. Phone/Fax

Practice location:
  • Phone: 617-742-0783
  • Fax:
Mailing address:
  • Phone: 845-445-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH240457
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: