Healthcare Provider Details

I. General information

NPI: 1154681526
Provider Name (Legal Business Name): XIAOSUN ZHOU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2012
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 AMSTERDAM AVE
NEW YORK NY
10025-1716
US

IV. Provider business mailing address

1411 61ST ST FL 2
BROOKLYN NY
11219-5408
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD472985
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: