Provider Demographics
NPI:1497026553
Name:ZHANG, JIN (DO)
Entity Type:Individual
Prefix:DR
First Name:JIN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13107 40TH RD
Mailing Address - Street 2:STE E18
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5205
Mailing Address - Country:US
Mailing Address - Phone:718-353-8050
Mailing Address - Fax:718-353-2085
Practice Address - Street 1:13107 40TH RD
Practice Address - Street 2:STE E18
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5205
Practice Address - Country:US
Practice Address - Phone:718-353-8050
Practice Address - Fax:718-353-2085
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263033207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty