Provider Demographics
NPI:1093056855
Name:ZHAO GASTROENTEROLOGY & HEPATOLOGY PC
Entity Type:Organization
Organization Name:ZHAO GASTROENTEROLOGY & HEPATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:XINYU
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-886-2488
Mailing Address - Street 1:16 BRISTOL DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3944
Mailing Address - Country:US
Mailing Address - Phone:917-767-8298
Mailing Address - Fax:
Practice Address - Street 1:4199 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3821
Practice Address - Country:US
Practice Address - Phone:718-886-2488
Practice Address - Fax:718-886-5386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty