Provider Demographics
NPI:1811987340
Name:ZHU, TONG (MD)
Entity type:Individual
Prefix:DR
First Name:TONG
Middle Name:
Last Name:ZHU
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 1:1 ELLIOT WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3502
Mailing Address - Country:US
Mailing Address - Phone:603-627-1669
Mailing Address - Fax:603-624-2297
Practice Address - Street 1:1 ELLIOT WAY STE 100
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-627-1669
Practice Address - Fax:603-624-2297
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217618207R00000X
NH14005207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2098415Medicaid
MA467883OtherTUFTS HEALTH PLAN
MAJ26846OtherBCBS MA
MAA36359Medicare ID - Type Unspecified
I00555Medicare UPIN