Healthcare Provider Details

I. General information

NPI: 1033259494
Provider Name (Legal Business Name): QIYING ZHOU LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 N MAIN ST
MILLTOWN NJ
08850-1524
US

IV. Provider business mailing address

5 PARK TER
NORTH BRUNSWICK NJ
08902-2666
US

V. Phone/Fax

Practice location:
  • Phone: 848-228-9739
  • Fax:
Mailing address:
  • Phone: 848-228-9739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00296500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: