Provider Demographics
NPI:1073080602
Name:GAO, JINGZHE (RN)
Entity Type:Individual
Prefix:
First Name:JINGZHE
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 AMHERST AVE APT 132
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4330
Mailing Address - Country:US
Mailing Address - Phone:315-717-7646
Mailing Address - Fax:
Practice Address - Street 1:MEDSTAR NATIONAL REHABILITATION NETWORK
Practice Address - Street 2:102 IRVING STREET, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-877-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY726472-1163W00000X
DCRN1049650163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse