Provider Demographics
NPI:1841369360
Name:ZHAO, XINYU (MD)
Entity type:Individual
Prefix:DR
First Name:XINYU
Middle Name:
Last Name:ZHAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BRISTOL DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3944
Mailing Address - Country:US
Mailing Address - Phone:917-767-8298
Mailing Address - Fax:
Practice Address - Street 1:4199 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3821
Practice Address - Country:US
Practice Address - Phone:718-886-2488
Practice Address - Fax:718-886-5386
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241984207R00000X, 207RI0008X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology