Provider Demographics
NPI:1568091759
Name:ZHAO, ZITING (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:ZITING
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 PRINCE ST STE 4F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5308
Mailing Address - Country:US
Mailing Address - Phone:718-939-3780
Mailing Address - Fax:
Practice Address - Street 1:3907 PRINCE ST STE 4F
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5308
Practice Address - Country:US
Practice Address - Phone:718-939-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF309570363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health