Provider Demographics
NPI:1093730335
Name:ZHANG, FONTINE (MD)
Entity Type:Individual
Prefix:
First Name:FONTINE
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SPRING ST
Mailing Address - Street 2:JUDSON HEALTH CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-4107
Mailing Address - Country:US
Mailing Address - Phone:212-925-5000
Mailing Address - Fax:
Practice Address - Street 1:34 SPRING ST
Practice Address - Street 2:JUDSON HEALTH CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4107
Practice Address - Country:US
Practice Address - Phone:212-925-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59198Medicare UPIN
NY27N681Medicare ID - Type Unspecified