=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851526651
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YAN ZHANG MD, PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2009
-----------------------------------------------------
Last Update Date | 07/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 80 SEYMOUR STREET HARTFORD HOSPITAL NEUROLOGY DEPT
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06102-5037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-545-3621
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 85 SEYMOUR ST STE 815
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06106-5527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-972-3600
-----------------------------------------------------
Fax | 860-545-5003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 050161
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084E0001X
-----------------------------------------------------
Taxonomy Name | Epilepsy Physician
-----------------------------------------------------
License Number | 050161
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------