Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 40QA01844300 | NJ |
Y | 2251X0800X | Physical Therapist - Orthopedic | 044048 | NY |
NPI | 1053877860 |
---|---|
Provider Name | Alexander Zhao |
First Address | New York, NY 10016-6575 |
Second Address | New York, NY 10036-8107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2019 |
Last Update Date | 19/06/2019 |