Provider Demographics
NPI:1366522054
Name:ZHANG, WEI (OD)
Entity type:Individual
Prefix:DR
First Name:WEI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MEMORIAL HWY
Mailing Address - Street 2:APT 7H
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-8312
Mailing Address - Country:US
Mailing Address - Phone:914-355-2794
Mailing Address - Fax:
Practice Address - Street 1:161 CENTEREACH MALL
Practice Address - Street 2:WAL-MART VISION CENTER
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-2750
Practice Address - Country:US
Practice Address - Phone:631-467-0402
Practice Address - Fax:631-585-0425
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2010-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006477152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A300000775OtherMEDICARE PTAN