Provider Demographics
NPI:1043897671
Name:ZHANG, BERTIE
Entity type:Individual
Prefix:
First Name:BERTIE
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2147 2ND AVE APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3254
Mailing Address - Country:US
Mailing Address - Phone:914-792-8398
Mailing Address - Fax:
Practice Address - Street 1:170 E 77TH ST PH B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1919
Practice Address - Country:US
Practice Address - Phone:914-434-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program