Provider Demographics
NPI:1861051575
Name:ZHANG, JOHNSON (DO)
Entity type:Individual
Prefix:
First Name:JOHNSON
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 BERGENWOOD AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2750
Mailing Address - Country:US
Mailing Address - Phone:732-725-5266
Mailing Address - Fax:
Practice Address - Street 1:255 GREENWICH ST RM 520
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-5504
Practice Address - Country:US
Practice Address - Phone:646-738-9689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11460300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine