Provider Demographics
NPI:1154482859
Name:ZHANG, LIXIN (MD)
Entity Type:Individual
Prefix:
First Name:LIXIN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 SHERIDAN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1727
Mailing Address - Country:US
Mailing Address - Phone:716-250-2000
Mailing Address - Fax:716-250-2040
Practice Address - Street 1:3980 SHERIDAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-250-2000
Practice Address - Fax:716-636-1365
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2276422084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000527461003OtherBLUE CROSS & BLUE SHIELD
NY0112192OtherINDEPENDENT HEALTH
NY000527461002OtherBLUE CROSS & BLUE SHIELD
NY00026731202OtherUNIVERA
NY02505920Medicaid
NYRA2134Medicare ID - Type Unspecified
NY02505920Medicaid