Provider Demographics
NPI:1356366629
Name:ZHU, YONG J (DPM)
Entity type:Individual
Prefix:DR
First Name:YONG
Middle Name:J
Last Name:ZHU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2412
Mailing Address - Country:US
Mailing Address - Phone:908-576-0880
Mailing Address - Fax:908-576-0881
Practice Address - Street 1:188 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2412
Practice Address - Country:US
Practice Address - Phone:908-576-0880
Practice Address - Fax:908-576-0881
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005907213ES0103X
NJ25MD00288500213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
V11245Medicare UPIN
NJ1356366629Medicare NSC