Healthcare Provider Details

I. General information

NPI: 1033610779
Provider Name (Legal Business Name): HYDE ZHUANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 02/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6135 JUNCTION BLVD
REGO PARK NY
11374-2771
US

IV. Provider business mailing address

6406 10TH AVE
BROOKLYN NY
11219-5533
US

V. Phone/Fax

Practice location:
  • Phone: 718-760-7860
  • Fax:
Mailing address:
  • Phone: 917-379-4935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: