Provider Demographics
NPI:1770977944
Name:ZHANG, ALICE Y (MD)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:Y
Last Name:ZHANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:658 MALTA AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020
Mailing Address - Country:US
Mailing Address - Phone:518-580-0553
Mailing Address - Fax:518-580-0557
Practice Address - Street 1:658 MALTA AVE
Practice Address - Street 2:STE 101
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020
Practice Address - Country:US
Practice Address - Phone:518-580-0553
Practice Address - Fax:518-580-0557
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2023-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101266894207W00000X
NY307913-01207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03425445Medicaid