Healthcare Provider Details

I. General information

NPI: 1497667471
Provider Name (Legal Business Name): IVY ZHENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 11TH ST
PHILADELPHIA PA
19107-4870
US

IV. Provider business mailing address

405 JONATHANS COVE CT
VIRGINIA BEACH VA
23464-1866
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6000
  • Fax:
Mailing address:
  • Phone: 757-752-5135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: