Provider Demographics
NPI:1285665737
Name:ZHANG, GANG (DPT)
Entity Type:Individual
Prefix:
First Name:GANG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9231 57TH AVE
Mailing Address - Street 2:APT 5D
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5024
Mailing Address - Country:US
Mailing Address - Phone:917-455-2172
Mailing Address - Fax:
Practice Address - Street 1:227 MADISON ST
Practice Address - Street 2:DEPARTMENT OF REHAB
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7537
Practice Address - Country:US
Practice Address - Phone:212-238-7891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024950225100000X
NY38241171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ239820801Medicare PIN