Provider Demographics
NPI:1841042744
Name:ZHANG, SANDY (APRN)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CLARA DR
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-1959
Mailing Address - Country:US
Mailing Address - Phone:860-572-5782
Mailing Address - Fax:860-865-2385
Practice Address - Street 1:23 CLARA DR
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-1959
Practice Address - Country:US
Practice Address - Phone:860-572-5782
Practice Address - Fax:860-865-2385
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.013047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily