Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 020944-1 | NY |
NPI | 1003365735 |
---|---|
Provider Name | Di Zhang |
First Address | Flushing, NY 11355-5540 |
Second Address | Flushing, NY 11355-5540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2016 |
Last Update Date | 22/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020944-1 | LICENSE# (01) | NY |