Healthcare Provider Details

I. General information

NPI: 1356319016
Provider Name (Legal Business Name): DR. HENRY HAIFENG ZHOU
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W MAIN ST SUITE 16
WYCKOFF NJ
07481-1439
US

IV. Provider business mailing address

20 BURNING HOLLOW RD
SADDLE RIVER NJ
07458-2939
US

V. Phone/Fax

Practice location:
  • Phone: 201-847-9403
  • Fax:
Mailing address:
  • Phone: 201-962-2620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA06791300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: