Provider Demographics
NPI:1619597937
Name:ZHANG, ZICHEN (LIC AC, MAC, MB)
Entity Type:Individual
Prefix:MR
First Name:ZICHEN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:LIC AC, MAC, MB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1970
Mailing Address - Country:US
Mailing Address - Phone:508-351-1655
Mailing Address - Fax:
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1970
Practice Address - Country:US
Practice Address - Phone:508-351-1655
Practice Address - Fax:978-440-8108
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA284099171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist