Healthcare Provider Details

I. General information

NPI: 1699354332
Provider Name (Legal Business Name): DAN ZHAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 PLEASANT ST
FALL RIVER MA
02721-3005
US

IV. Provider business mailing address

125 CLIFFORD ST APT 324
PROVIDENCE RI
02903-4240
US

V. Phone/Fax

Practice location:
  • Phone: 508-676-3292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number1022169
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: