Healthcare Provider Details

I. General information

NPI: 1578459723
Provider Name (Legal Business Name): XINNAN ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 SUMMIT AVE UNIT 202
JERSEY CITY NJ
07306-3399
US

IV. Provider business mailing address

425 SUMMIT AVE UNIT 202
JERSEY CITY NJ
07306-3399
US

V. Phone/Fax

Practice location:
  • Phone: 424-471-2832
  • Fax:
Mailing address:
  • Phone: 424-471-2832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07282200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: