Healthcare Provider Details

I. General information

NPI: 1700816899
Provider Name (Legal Business Name): MING ZHONG ZHU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 E 17TH ST
BROOKLYN NY
11229-4403
US

IV. Provider business mailing address

2113 E 17TH ST
BROOKLYN NY
11229-4403
US

V. Phone/Fax

Practice location:
  • Phone: 718-998-0486
  • Fax: 718-998-2095
Mailing address:
  • Phone: 718-998-0486
  • Fax: 718-998-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200493
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: