Provider Demographics
NPI:1780771592
Name:ZUO, HAILIU (MD)
Entity type:Individual
Prefix:DR
First Name:HAILIU
Middle Name:
Last Name:ZUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 18 CORNISH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-779-8880
Mailing Address - Fax:718-779-8887
Practice Address - Street 1:83 18 CORNISH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-779-8880
Practice Address - Fax:718-779-8887
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192825207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01724083Medicaid
NY01724083Medicaid
NYF60927Medicare UPIN
NY00979AMedicare ID - Type UnspecifiedGHI-MEDICARE