Provider Demographics
NPI:1851798631
Name:ZHANG, BRYAN (CRNA)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:BAOTONG
Other - Middle Name:
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12302-6924
Mailing Address - Country:US
Mailing Address - Phone:786-303-1378
Mailing Address - Fax:
Practice Address - Street 1:47 NEW SCOTLAND AVE # MC131
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-23
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2322656367500000X
NY693858-1163W00000X
NY693858207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110126689AMedicaid