Provider Demographics
NPI:1073061164
Name:ZOU, CHANG BI
Entity type:Individual
Prefix:
First Name:CHANG BI
Middle Name:
Last Name:ZOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4199 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5164
Mailing Address - Country:US
Mailing Address - Phone:718-961-1836
Mailing Address - Fax:
Practice Address - Street 1:4199 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5164
Practice Address - Country:US
Practice Address - Phone:718-961-1897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-17
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020055363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant