Healthcare Provider Details

I. General information

NPI: 1386021095
Provider Name (Legal Business Name): JISHUN ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3902 UNION ST # 2
FLUSHING NY
11354-5514
US

IV. Provider business mailing address

15335 79TH ST
HOWARD BEACH NY
11414-1723
US

V. Phone/Fax

Practice location:
  • Phone: 718-661-1122
  • Fax:
Mailing address:
  • Phone: 347-237-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number060209
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: