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General NPI Number Information
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NPI Number | 1093056855
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Entity Type | Organization
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Legal Business Name | ZHAO GASTROENTEROLOGY & HEPATOLOGY PC
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 4199 MAIN ST STE 203
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City | FLUSHING
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State | NY
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Zip | 11355-3821
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Country | US
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Telephone | 718-886-2488
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Fax | 718-886-5386
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Provider Business Mailing Address
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Address Line | 16 BRISTOL DR
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City | MANHASSET
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State | NY
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Zip | 11030-3944
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Country | US
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Telephone | 917-767-8298
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. XINYU ZHAO
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Credential | MD
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Telephone | 718-886-2488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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