Healthcare Provider Details

I. General information

NPI: 1770147563
Provider Name (Legal Business Name): ZHI-YANG TSUN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 802
NEW CASTLE NH
03854
US

IV. Provider business mailing address

PO BOX 802
NEW CASTLE NH
03854
US

V. Phone/Fax

Practice location:
  • Phone: 617-249-3690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number24774
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: