Basic Information
Provider Information
NPI: 1538685797
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHANG
FirstName: JUNJI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 CREDIT UNION WAY FL 3
Address2:  
City: RANDOLPH
State: MA
PostalCode: 023684633
CountryCode: US
TelephoneNumber: 7819613370
FaxNumber: 7819611291
Practice Location
Address1: 540 GALLIVAN BLVD
Address2:  
City: DORCHESTER
State: MA
PostalCode: 021245400
CountryCode: US
TelephoneNumber: 6172821200
FaxNumber: 6172829988
Other Information
ProviderEnumerationDate: 08/19/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X2085CTN Chiropractic ProvidersChiropractor 
111N00000X3600MAY Chiropractic ProvidersChiropractor 

No ID Information.


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