Healthcare Provider Details

I. General information

NPI: 1689150476
Provider Name (Legal Business Name): ZHENMING TIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2018
Last Update Date: 07/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6304 5TH AVE
BROOKLYN NY
11220-4911
US

IV. Provider business mailing address

155 CLAREMONT AVE APT 304
NEW YORK NY
10027-4003
US

V. Phone/Fax

Practice location:
  • Phone: 718-576-3610
  • Fax:
Mailing address:
  • Phone: 929-339-9468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: