Provider Demographics
NPI:1316213135
Name:ZHANG, NASEN JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NASEN
Middle Name:JONATHAN
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 1:259 1ST ST
Mailing Address - Street 2:WINTHROP 2, ROOM 291
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3957
Mailing Address - Country:US
Mailing Address - Phone:516-663-8963
Mailing Address - Fax:516-663-8964
Practice Address - Street 1:259 1ST ST
Practice Address - Street 2:WINTHROP 2, ROOM 291
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3957
Practice Address - Country:US
Practice Address - Phone:516-663-8963
Practice Address - Fax:516-663-8964
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY277272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program