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General NPI Number Information
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NPI Number | 1164634432
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Entity Type | Organization
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Legal Business Name | JIANSHENG ZHAO MEDICAL PC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 39-07 PRINCE STREET SUITE 4F
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City | FLUSHING
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State | NY
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Zip | 11354-5399
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Country | US
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Telephone | 718-939-3780
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Fax | 718-939-7040
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Provider Business Mailing Address
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Address Line | 3907 PRINCE ST SUITE 4F
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City | FLUSHING
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State | NY
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Zip | 11354-5399
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Country | US
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Telephone | 718-939-3780
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Fax | 718-939-7040
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. JIANSHENG ZHAO
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Credential | MD
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Telephone | 718-939-3780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | NY203543
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License Number State | NY
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