Provider Demographics
NPI:1538752100
Name:ZENG, IRIS AISHAN (PA-C)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:AISHAN
Last Name:ZENG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON ST STE 563
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1629
Mailing Address - Country:US
Mailing Address - Phone:617-219-1285
Mailing Address - Fax:617-219-1289
Practice Address - Street 1:2000 WASHINGTON ST STE 563
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1629
Practice Address - Country:US
Practice Address - Phone:617-219-1285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA8881363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical