Provider Demographics
NPI:1023047990
Name:ZHU, TRACEY (MD)
Entity type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:
Last Name:ZHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06852-0509
Mailing Address - Country:US
Mailing Address - Phone:203-847-5351
Mailing Address - Fax:203-847-3186
Practice Address - Street 1:1213 CHAPEL ST
Practice Address - Street 2:NEW HAVEN MEDICAL SPORTS & OCCUPATIONAL HEALTH
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-776-3375
Practice Address - Fax:203-776-3171
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT038469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H19014Medicare UPIN