Healthcare Provider Details

I. General information

NPI: 1730648155
Provider Name (Legal Business Name): LEI ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 5TH AVE # 1722
NEW YORK NY
10175-0003
US

IV. Provider business mailing address

19 W 21ST ST RM 1003
NEW YORK NY
10010-6843
US

V. Phone/Fax

Practice location:
  • Phone: 917-740-5287
  • Fax:
Mailing address:
  • Phone: 917-740-5287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number9725362
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402696
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: