Healthcare Provider Details

I. General information

NPI: 1356366629
Provider Name (Legal Business Name): YONG J ZHU DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 MOUNTAIN AVE
HACKETTSTOWN NJ
07840-2412
US

IV. Provider business mailing address

188 MOUNTAIN AVE
HACKETTSTOWN NJ
07840-2412
US

V. Phone/Fax

Practice location:
  • Phone: 908-576-0880
  • Fax: 908-576-0881
Mailing address:
  • Phone: 908-576-0880
  • Fax: 908-576-0881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005907
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00288500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: