Healthcare Provider Details

I. General information

NPI: 1265832190
Provider Name (Legal Business Name): YINGNA ZHOU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 04/07/2020
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 JASON PL, SUITE 201
MIDDLETOWN NY
10940-1094
US

IV. Provider business mailing address

14 JASON PL , SUITE 201
MIDDLETOWN NY
10940
US

V. Phone/Fax

Practice location:
  • Phone: 845-800-5118
  • Fax:
Mailing address:
  • Phone: 845-800-5115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA09942900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number286505
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: