Provider Demographics
NPI:1376954511
Name:WANG, YU ZHENG
Entity type:Individual
Prefix:DR
First Name:YU ZHENG
Middle Name:
Last Name:WANG
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 1:6136 SPRINGFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2336
Mailing Address - Country:US
Mailing Address - Phone:718-819-0881
Mailing Address - Fax:718-819-0891
Practice Address - Street 1:4207 KISSENA BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3297
Practice Address - Country:US
Practice Address - Phone:347-368-6681
Practice Address - Fax:347-368-6560
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist