Provider Demographics
NPI:1417046921
Name:JIN, ZAIWANG PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAIWANG
Middle Name:PAUL
Last Name:JIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:865 BROADWAY AVE APT 133A
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-4942
Mailing Address - Country:US
Mailing Address - Phone:631-854-1222
Mailing Address - Fax:631-854-1226
Practice Address - Street 1:365 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3145
Practice Address - Country:US
Practice Address - Phone:631-854-1222
Practice Address - Fax:631-854-1226
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2029632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G35286Medicare UPIN