Provider Demographics
NPI:1831468115
Name:LU, ZHEN
Entity Type:Individual
Prefix:
First Name:ZHEN
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7132 162ND ST
Mailing Address - Street 2:APT 3
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4237
Mailing Address - Country:US
Mailing Address - Phone:718-530-2055
Mailing Address - Fax:
Practice Address - Street 1:810 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6811
Practice Address - Country:US
Practice Address - Phone:914-235-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist