Provider Demographics
NPI:1437103082
Name:ZHENG, SU (MD)
Entity Type:Individual
Prefix:DR
First Name:SU
Middle Name:
Last Name:ZHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SUMMER ST
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1216
Mailing Address - Country:US
Mailing Address - Phone:508-363-6154
Mailing Address - Fax:508-363-6043
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-363-6154
Practice Address - Fax:508-363-6043
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD11601207ZP0101X
MA230415207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7056927Medicaid
MA110075070AMedicaid
RII21586Medicare UPIN
RI7056927Medicaid