Healthcare Provider Details

I. General information

NPI: 1922136753
Provider Name (Legal Business Name): BRONX FOOT REHABILITATION ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 11/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3112 WEBSTER AVE GROUND FLOOR
BRONX NY
10467-4926
US

IV. Provider business mailing address

3112 WEBSTER AVE GROUND FLOOR
BRONX NY
10467-4926
US

V. Phone/Fax

Practice location:
  • Phone: 718-655-3410
  • Fax: 718-655-3475
Mailing address:
  • Phone: 718-655-3410
  • Fax: 718-655-3475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JIAN ZHANG
Title or Position: PRESIDENT
Credential: DPM
Phone: 718-655-3410