Healthcare Provider Details

I. General information

NPI: 1780177758
Provider Name (Legal Business Name): YU ZHAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 LONG POND RD
ROCHESTER NY
14626-4122
US

IV. Provider business mailing address

211 PARK ST
ATTLEBORO MA
02703-3143
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-7746
  • Fax: 585-723-7834
Mailing address:
  • Phone: 508-222-5200
  • Fax: 508-236-7335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101287850
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1013248
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD17509
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: