Provider Demographics
NPI:1457642217
Name:ZHONG, MICHELLE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ZHONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 54TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220
Mailing Address - Country:US
Mailing Address - Phone:718-633-6850
Mailing Address - Fax:212-226-9810
Practice Address - Street 1:840 54TH ST
Practice Address - Street 2:HOUSE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3209
Practice Address - Country:US
Practice Address - Phone:718-633-6850
Practice Address - Fax:212-226-9810
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist