Provider Demographics
NPI:1477377976
Name:ZHANG, LIJING (AGNP)
Entity type:Individual
Prefix:
First Name:LIJING
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13107 40TH RD # 5E08
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5116
Mailing Address - Country:US
Mailing Address - Phone:718-888-9183
Mailing Address - Fax:
Practice Address - Street 1:13107 40TH RD # 5E08
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5116
Practice Address - Country:US
Practice Address - Phone:718-888-9183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY807729163W00000X
NY2024067555363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse