Provider Demographics
NPI:1841784733
Name:WELLSURE MEDICAL PRACTICE P.C.
Entity Type:Organization
Organization Name:WELLSURE MEDICAL PRACTICE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZIQIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-888-0722
Mailing Address - Street 1:3712 PRINCE ST STE 8D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4652
Mailing Address - Country:US
Mailing Address - Phone:718-888-0722
Mailing Address - Fax:718-888-0744
Practice Address - Street 1:3712 PRINCE ST STE 8D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4652
Practice Address - Country:US
Practice Address - Phone:718-888-0722
Practice Address - Fax:718-888-0744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty