Provider Demographics
NPI:1689674855
Name:ZHOU, ERIC YUANCHUN (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:YUANCHUN
Last Name:ZHOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YUANCHUN
Other - Middle Name:
Other - Last Name:ZHOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39 EAST BROADWAY
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002
Mailing Address - Country:US
Mailing Address - Phone:212-766-8168
Mailing Address - Fax:212-766-8169
Practice Address - Street 1:98 E BROADWAY FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7181
Practice Address - Country:US
Practice Address - Phone:212-966-2699
Practice Address - Fax:212-966-1206
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230718207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02694351Medicaid
7X2631Medicare ID - Type Unspecified
NY02694351Medicaid