MEDICARE: TAIKANG MEDICAL P.C

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	261QH0100X	Health Service Clinic/Center	222053	NY
2	261QM2500X	Medical Specialty Clinic/Center	222053	NY
3	261QP2300X	Primary Care Clinic/Center	222052	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992958144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAIKANG MEDICAL P.C

Provider Business Mailing Address
First Line	:	1553 84TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5618 7TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3510
Country	:	US
Telephone Number	:	718-492-2008
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ZHIGUANG ZHANG
Credential	:	MD
Telephone Number	:	347-268-8788

Provider Enumeration Date	:	11/01/2008
Last Update Date	:	11/01/2008

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Directions to “TAIKANG MEDICAL P.C ” Practice Location

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