Provider Demographics
NPI:1780016535
Name:ZHAO, ADAM YI (OD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:YI
Last Name:ZHAO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 AMWELL RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1225
Mailing Address - Country:US
Mailing Address - Phone:908-336-3886
Mailing Address - Fax:
Practice Address - Street 1:390 AMWELL RD
Practice Address - Street 2:SUITE 401
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1225
Practice Address - Country:US
Practice Address - Phone:908-336-3886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-04
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00650000152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist