Provider Demographics
NPI:1528605326
Name:ZHANG, FANG (SOCIAL WORK)
Entity Type:Individual
Prefix:
First Name:FANG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 HARDENBURGH AVE
Mailing Address - Street 2:
Mailing Address - City:HAWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07641
Mailing Address - Country:US
Mailing Address - Phone:718-715-6707
Mailing Address - Fax:
Practice Address - Street 1:4360 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6533
Practice Address - Country:US
Practice Address - Phone:718-818-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-30
Last Update Date:2019-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101364104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker