Provider Demographics
NPI:1427083880
Name:ZHENG, RONGLAN (MD, PHD)
Entity type:Individual
Prefix:
First Name:RONGLAN
Middle Name:
Last Name:ZHENG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:RHODA
Other - Middle Name:
Other - Last Name:ZHENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8 DELAMAR CT
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1792
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2375 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4258
Practice Address - Country:US
Practice Address - Phone:631-549-8120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229151208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02443089Medicaid
NYA400189408OtherPTAN
NY0392JER911OtherPTAN