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General NPI Number Information
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NPI Number | 1215334669
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Entity Type | Individual
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Provider Name | ZENGLIU SU DABCC
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Gender | Male
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 486 GALLIMORE DAIRY RD
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City | GREENSBORO
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State | NC
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Zip | 27409-9725
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Country | US
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Telephone | 336-387-7642
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Fax | 336-387-7601
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Provider Business Mailing Address
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Address Line | 486 GALLIMORE DAIRY RD
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City | GREENSBORO
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State | NC
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Zip | 27409-9725
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Country | US
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Telephone | 336-387-7642
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Fax | 336-387-7601
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | SUXXZ1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | 25MS00016100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | 33537DIR-0
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | DI 45675
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License Number State | FL
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