Healthcare Provider Details

I. General information

NPI: 1427007871
Provider Name (Legal Business Name): YANMING ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 10/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE MEMORIAL SLOAN KETTERING CANCER CENTER, PATHOLOGY,
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

1210 E 48TH ST
CHICAGO IL
60615-1906
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-8489
  • Fax: 773-834-1351
Mailing address:
  • Phone: 773-538-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SC0300X
TaxonomyClinical Cytogenetics Physician
License Number2005203
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: