Basic Information
| Provider Information | |||||||||
| NPI: | 1134362254 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ZHAO | ||||||||
| FirstName: | PENG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3450 WAYNE AVENUE, APT 18S | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3123997542 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8906 135TH ST # 5H | ||||||||
| Address2: | DEPT. OF REHABILITATION MEDICINE, JAMAICA HOSPITAL | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114182821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182066894 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2009 | ||||||||
| LastUpdateDate: | 04/20/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 252735 | NY | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.