Provider Demographics
NPI:1790851541
Name:ZHANG, TIANSHU (MD)
Entity Type:Individual
Prefix:
First Name:TIANSHU
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2291
Mailing Address - Country:US
Mailing Address - Phone:732-632-8858
Mailing Address - Fax:732-632-8861
Practice Address - Street 1:227 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2291
Practice Address - Country:US
Practice Address - Phone:732-632-8858
Practice Address - Fax:732-632-8861
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA067405002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8649502Medicaid
G86894Medicare UPIN
017865Medicare ID - Type Unspecified