Provider Demographics
NPI:1821639188
Name:ZHANG, CATHY KEXIN (RD)
Entity Type:Individual
Prefix:
First Name:CATHY KEXIN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 94TH ST APT 6I
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5687
Mailing Address - Country:US
Mailing Address - Phone:607-379-0184
Mailing Address - Fax:
Practice Address - Street 1:345 E 94TH ST APT 6I
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5687
Practice Address - Country:US
Practice Address - Phone:607-379-0184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86067445133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered