Healthcare Provider Details

I. General information

NPI: 1972419380
Provider Name (Legal Business Name): ZONGBO ZHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BOB ZHANG

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SKYLINE DR
HAWTHORNE NY
10532-2134
US

IV. Provider business mailing address

211 MAMARONECK RD
SCARSDALE NY
10583-7259
US

V. Phone/Fax

Practice location:
  • Phone: 914-594-2700
  • Fax:
Mailing address:
  • Phone: 914-886-7042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: