Healthcare Provider Details

I. General information

NPI: 1447162011
Provider Name (Legal Business Name): TINA ZHENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5604 7TH AVE STE 1
BROOKLYN NY
11220-4660
US

IV. Provider business mailing address

15015 20TH AVE
WHITESTONE NY
11357-3132
US

V. Phone/Fax

Practice location:
  • Phone: 718-360-7666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: