Provider Demographics
NPI:1295116002
Name:ZHAO, LINXI
Entity type:Individual
Prefix:
First Name:LINXI
Middle Name:
Last Name:ZHAO
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 1:84 E BROAD ST STE 2
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-1844
Mailing Address - Country:US
Mailing Address - Phone:609-466-0055
Mailing Address - Fax:
Practice Address - Street 1:84 E BROAD ST STE 2
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-1844
Practice Address - Country:US
Practice Address - Phone:609-466-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008301152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist