Healthcare Provider Details

I. General information

NPI: 1881731479
Provider Name (Legal Business Name): CHENG ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 04/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 BAINBRIDGE AVENUE
BRONX NY
10467
US

IV. Provider business mailing address

3332 ROCHAMBEAU AVE FL 3
BRONX NY
10467-2836
US

V. Phone/Fax

Practice location:
  • Phone: 410-812-3362
  • Fax:
Mailing address:
  • Phone: 718-920-2020
  • Fax: 718-515-3734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number258318
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: