Healthcare Provider Details

I. General information

NPI: 1205936762
Provider Name (Legal Business Name): FRANK LIXUN ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NESCONSET HIGHWAY, BLDG 18B
STONY BROOK NY
11790
US

IV. Provider business mailing address

2500 NESCONSET HIGHWAY, BLDG 18B
STONY BROOK NY
11790
US

V. Phone/Fax

Practice location:
  • Phone: 631-246-6018
  • Fax: 631-246-6017
Mailing address:
  • Phone: 631-246-6018
  • Fax: 631-246-6017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number204359
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number204359
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: