Healthcare Provider Details

I. General information

NPI: 1811671845
Provider Name (Legal Business Name): ZHISHENG SHAO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHASEN SHAO DPM

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 5TH AVE APT 1E
NEW YORK NY
10021-2680
US

IV. Provider business mailing address

930 5TH AVE APT 1E
NEW YORK NY
10021-2680
US

V. Phone/Fax

Practice location:
  • Phone: 212-570-9300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN007520
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: