Healthcare Provider Details

I. General information

NPI: 1306882444
Provider Name (Legal Business Name): JIAN ZHANG DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 WESTCHESTER AVE MEDUCAL VILLAGE
BRONX NY
10461-4500
US

IV. Provider business mailing address

28 WATERVIEW DR
OSSINING NY
10562-1641
US

V. Phone/Fax

Practice location:
  • Phone: 718-518-9304
  • Fax: 718-518-9401
Mailing address:
  • Phone: 718-655-3410
  • Fax: 718-655-3475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN005547
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: