Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 219658 | NY |
N | 2081P2900X | Pain Medicine | 219658 | NY |
NPI | 1376589770 |
---|---|
Provider Name | Shuangwu Zheng |
First Address | Scarsdale, NY 10583-3206 |
Second Address | Poughkeepsie, NY 12601-1335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 14/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06250 | GHI MEDICARE PIN (01) | NY |
219658 | STATE LICENSE (01) | NY |
BZ7055658 | DEA CERTIFICATE (01) | NY |
H30143 | (02) | NY |