Provider Demographics
NPI:1790712545
Name:ZHENG, TAO (MD)
Entity Type:Individual
Prefix:
First Name:TAO
Middle Name:
Last Name:ZHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CEDAR STREET, TAC S-217
Mailing Address - Street 2:YALE UNIVERSITY SCH. OF MED, ALLERGY & CLIN. IMMUNOLOGY
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-785-4143
Mailing Address - Fax:203-785-3229
Practice Address - Street 1:1 PARK STREET
Practice Address - Street 2:YALE NEW HAVEN HOSPITAL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520
Practice Address - Country:US
Practice Address - Phone:203-785-4143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD62474207K00000X
CT037944207K00000X
RIMD15980207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406489500Medicaid
MD406489500Medicaid
MDKR63K446Medicare PIN