Provider Demographics
NPI:1003026519
Name:ZHANG, NANCY XIAO (OMD)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:XIAO
Last Name:ZHANG
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:MRS
Other - First Name:XIAO
Other - Middle Name:LAN
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OMD
Mailing Address - Street 1:21919 PECK AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1121
Mailing Address - Country:US
Mailing Address - Phone:718-406-7256
Mailing Address - Fax:
Practice Address - Street 1:11045 QUEENS BLVD
Practice Address - Street 2:SUITE AA
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5501
Practice Address - Country:US
Practice Address - Phone:718-268-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001261-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist