Provider Demographics
NPI:1396849790
Name:ZHOU, WENJING (MD)
Entity type:Individual
Prefix:
First Name:WENJING
Middle Name:
Last Name:ZHOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3907 PRINCE STREET
Mailing Address - Street 2:PRINCE CENTER SUITE 3J
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-961-9025
Mailing Address - Fax:718-961-9026
Practice Address - Street 1:3907 PRINCE STREET
Practice Address - Street 2:PRINCE CENTER SUITE 3J
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-961-9025
Practice Address - Fax:718-961-9026
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY214339208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02021103Medicaid