Healthcare Provider Details

I. General information

NPI: 1548406747
Provider Name (Legal Business Name): MINSHENG ZHUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 BARD AVE
STATEN ISLAND NY
10310-1664
US

IV. Provider business mailing address

458 ANNADALE RD
STATEN ISLAND NY
10312-3116
US

V. Phone/Fax

Practice location:
  • Phone: 718-818-2752
  • Fax: 718-818-1890
Mailing address:
  • Phone: 718-878-5316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number247541
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number247541
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: