Provider Demographics
NPI:1992252126
Name:ZHU, JACQUI CONG (MBBS)
Entity type:Individual
Prefix:DR
First Name:JACQUI
Middle Name:CONG
Last Name:ZHU
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E 63RD ST
Mailing Address - Street 2:APT 6S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7919
Mailing Address - Country:US
Mailing Address - Phone:917-865-3085
Mailing Address - Fax:
Practice Address - Street 1:504 E 63RD ST
Practice Address - Street 2:APT 6S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7919
Practice Address - Country:US
Practice Address - Phone:917-865-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist