Provider Demographics
NPI:1760936140
Name:ZHANG, WAN QING (LAC)
Entity Type:Individual
Prefix:
First Name:WAN
Middle Name:QING
Last Name:ZHANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 COLONY CT
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3509
Mailing Address - Country:US
Mailing Address - Phone:716-390-1519
Mailing Address - Fax:
Practice Address - Street 1:109 COLONY CT
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3509
Practice Address - Country:US
Practice Address - Phone:716-390-1519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005731171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist