MEDICARE: JESSLYN SHAOLIN ZHANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	069650	NY

General Provider Information

NPI Number	:	1962119057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSLYN SHAOLIN ZHANG

Provider Business Mailing Address
First Line	:	2021 84TH ST APT 5G
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-2437
Country	:	US
Telephone Number	:	917-362-0067
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 3RD AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-6331
Country	:	US
Telephone Number	:	347-913-4656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2022
Last Update Date	:	10/31/2022

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