Healthcare Provider Details

I. General information

NPI: 1538793732
Provider Name (Legal Business Name): YI ZHANG MEDICAL WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4265 KISSENA BLVD # L1
FLUSHING NY
11355-3273
US

IV. Provider business mailing address

3815 CORPORAL STONE ST FL 2
BAYSIDE NY
11361-2140
US

V. Phone/Fax

Practice location:
  • Phone: 205-427-1290
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. YI ZHANG
Title or Position: OWNER
Credential: MD
Phone: 205-427-1290