1336203330 NPI number — DR. GUANGWEI ZHOU SCD, CCC-A

Table of content: DR. GUANGWEI ZHOU SCD, CCC-A (NPI 1336203330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336203330 NPI number — DR. GUANGWEI ZHOU SCD, CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHOU
Provider First Name:
GUANGWEI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
SCD, CCC-A
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336203330
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 HOPE AVE
Provider Second Line Business Mailing Address:
WL1134
Provider Business Mailing Address City Name:
WALTHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02453-2741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-216-2790
Provider Business Mailing Address Fax Number:
617-730-4829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 HOPE AVE
Provider Second Line Business Practice Location Address:
WL1134
Provider Business Practice Location Address City Name:
WALTHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02453-2741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-216-2790
Provider Business Practice Location Address Fax Number:
617-730-4829
Provider Enumeration Date:
12/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  690 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5100330 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com