Provider Demographics
NPI:1528283983
Name:ZEN, QIN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:QIN
Middle Name:
Last Name:ZEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PATROON CREEK BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-5013
Mailing Address - Country:US
Mailing Address - Phone:518-489-0044
Mailing Address - Fax:518-489-3591
Practice Address - Street 1:400 PATROON CREEK BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-5013
Practice Address - Country:US
Practice Address - Phone:518-489-0044
Practice Address - Fax:518-489-3591
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256255207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03226955Medicaid
P00852432OtherRAILROAD MEDICARE
NY03226955Medicaid
NYA400152889Medicare PIN