Provider Demographics
NPI:1306307574
Name:ZHAN, XIAO JUN
Entity type:Individual
Prefix:
First Name:XIAO JUN
Middle Name:
Last Name:ZHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:883 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4737
Mailing Address - Country:US
Mailing Address - Phone:718-283-8961
Mailing Address - Fax:718-635-8940
Practice Address - Street 1:883 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4737
Practice Address - Country:US
Practice Address - Phone:718-283-8961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant