Healthcare Provider Details
I. General information
NPI: 1942166954
Provider Name (Legal Business Name): AMY ZHANG, OD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4501 SINGER CT STE 105
CHANTILLY VA
20151-1733
US
IV. Provider business mailing address
14383 NEWBROOK DR STE 300 PMB 424
CHANTILLY VA
20151-4265
US
V. Phone/Fax
- Phone: 703-783-3992
- Fax:
- Phone: 510-209-8506
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WP0200X |
| Taxonomy | Pediatric Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
ZHANG
Title or Position: OPTOMETRIST
Credential: OD
Phone: 510-209-8506