Provider Demographics
NPI:1891008363
Name:ZHAO, AIYU
Entity Type:Individual
Prefix:
First Name:AIYU
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LANSING STREET
Mailing Address - Street 2:AUBURN MEMORIAL MEDICAL SERVICES, PC
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1944
Mailing Address - Country:US
Mailing Address - Phone:315-567-0455
Mailing Address - Fax:315-253-1795
Practice Address - Street 1:77 NELSON ST
Practice Address - Street 2:SUITE #120
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1944
Practice Address - Country:US
Practice Address - Phone:315-567-0390
Practice Address - Fax:315-252-8837
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY275387207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine