Healthcare Provider Details

I. General information

NPI: 1821243106
Provider Name (Legal Business Name): WENREN ZHUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WENREN ZHUANG

II. Dates (important events)

Enumeration Date: 11/30/2008
Last Update Date: 11/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18508 UNION TPKE SUITE 101
FRESH MEADOWS NY
11366-1700
US

IV. Provider business mailing address

7136 110TH ST APARTMENT 3E
FOREST HILLS NY
11375-4852
US

V. Phone/Fax

Practice location:
  • Phone: 718-264-7250
  • Fax: 718-264-7163
Mailing address:
  • Phone: 347-741-8889
  • Fax: 347-741-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number659948
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: