Healthcare Provider Details

I. General information

NPI: 1609294883
Provider Name (Legal Business Name): MENGLEI ZHU M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE DEPT OF
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

1275 YORK AVE DEPT OF
NEW YORK NY
10065-6007
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-3959
  • Fax:
Mailing address:
  • Phone:
  • Fax: 216-203-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number305560
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: