Provider Demographics
NPI:1821243106
Name:ZHUANG, WENREN
Entity Type:Individual
Prefix:
First Name:WENREN
Middle Name:
Last Name:ZHUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENREN
Other - Middle Name:
Other - Last Name:ZHUANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7136 110TH ST
Mailing Address - Street 2:APARTMENT 3E
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4852
Mailing Address - Country:US
Mailing Address - Phone:347-741-8889
Mailing Address - Fax:347-741-8889
Practice Address - Street 1:18508 UNION TPKE
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1700
Practice Address - Country:US
Practice Address - Phone:718-264-7250
Practice Address - Fax:718-264-7163
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-30
Last Update Date:2008-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY659948174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist