MEDICARE: MISS AITAO ZHANG LPN

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	171100000X	Acupuncturist	25003696	NY
2	164W00000X	Licensed Practical Nurse	10296755	NY

General Provider Information

NPI Number	:	1982903704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS AITAO ZHANG LPN

Provider Business Mailing Address
First Line	:	13537 37TH AVE APT 3D
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-6601
Country	:	US
Telephone Number	:	646-853-3391
Fax Number	:

Provider Business Practice Location Address
First Line	:	3531 9TH INFANTRY ST BOX 694
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	646-853-3391
Fax Number	:

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

Provider Enumeration Date	:	03/18/2011
Last Update Date	:	02/23/2015

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