Provider Demographics
NPI:1164541793
Name:ZHANG, WEIGUO (LAC, MPH)
Entity Type:Individual
Prefix:MR
First Name:WEIGUO
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:LAC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S JERSEY AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2035
Mailing Address - Country:US
Mailing Address - Phone:631-941-3232
Mailing Address - Fax:
Practice Address - Street 1:100 S JERSEY AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2035
Practice Address - Country:US
Practice Address - Phone:631-941-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000841171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist