Provider Demographics
NPI:1659301554
Name:ZHANG, YANLONG (MD, PHD)
Entity Type:Individual
Prefix:
First Name:YANLONG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CRANBERRY HL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7394
Mailing Address - Country:US
Mailing Address - Phone:678-679-9059
Mailing Address - Fax:205-579-9387
Practice Address - Street 1:1 CRANBERRY HL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7394
Practice Address - Country:US
Practice Address - Phone:678-679-9059
Practice Address - Fax:205-579-9387
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235171207ZP0102X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3897474Medicaid
TN4087733OtherBLUE CROSS BLUE SHIELD
TN4087733Medicaid
TN000000032352Medicaid
TN4087733Medicaid
TN3897475Medicare ID - Type Unspecified
TN3897474Medicaid