Provider Demographics
NPI:1982329207
Name:ZENG, WANYUN
Entity type:Individual
Prefix:MISS
First Name:WANYUN
Middle Name:
Last Name:ZENG
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 1:434 W 120TH ST APT 6M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6718
Mailing Address - Country:US
Mailing Address - Phone:347-610-0698
Mailing Address - Fax:
Practice Address - Street 1:7065 QUEENS BLVD APT 6C
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5160
Practice Address - Country:US
Practice Address - Phone:347-610-0698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119993104100000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker