1790712545 NPI number — TAO ZHENG M.D.

Table of content: TAO ZHENG M.D. (NPI 1790712545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790712545 NPI number — TAO ZHENG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHENG
Provider First Name:
TAO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1790712545
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 CEDAR STREET, TAC S-217
Provider Second Line Business Mailing Address:
YALE UNIVERSITY SCH. OF MED, ALLERGY & CLIN. IMMUNOLOGY
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-785-4143
Provider Business Mailing Address Fax Number:
203-785-3229

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 PARK STREET
Provider Second Line Business Practice Location Address:
YALE NEW HAVEN HOSPITAL
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-785-4143
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2006

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: 207K00000X , with the licence number:  D62474 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207K00000X , with the licence number: 037944 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207K00000X , with the licence number: MD15980 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 406489500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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