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General NPI Number Information
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NPI Number | 1891285755
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Entity Type | Individual
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Provider Name | FA J ZHANG
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Gender | Male
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 13514 NORTHERN BLVD # 2B
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 917-306-8190
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Fax |
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Provider Business Mailing Address
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Address Line | 13514 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11354-4007
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Country | US
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Telephone | 929-218-9132
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Fax |
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 2018051516280242252
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License Number State | NY
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