Healthcare Provider Details

I. General information

NPI: 1871953141
Provider Name (Legal Business Name): YAN HONG ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 03/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 ELDRIDGE ST
NEW YORK NY
10002-2924
US

IV. Provider business mailing address

184 ELDRIDGE ST
NEW YORK NY
10002-2924
US

V. Phone/Fax

Practice location:
  • Phone: 212-453-4509
  • Fax:
Mailing address:
  • Phone: 212-453-4509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number220049294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: