Provider Demographics
NPI:1477043644
Name:ZHANG, MIKE (DAOM)
Entity type:Individual
Prefix:DR
First Name:MIKE
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 NEWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1620
Mailing Address - Country:US
Mailing Address - Phone:917-399-5277
Mailing Address - Fax:
Practice Address - Street 1:46 E PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3503
Practice Address - Country:US
Practice Address - Phone:516-208-5388
Practice Address - Fax:516-665-3517
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006275171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty