Healthcare Provider Details

I. General information

NPI: 1275117806
Provider Name (Legal Business Name): CHENYU ZHANG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 05/10/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

157A BERRY HILL RD
SYOSSET NY
11791-2608
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-3041
  • Fax:
Mailing address:
  • Phone: 516-355-1609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: