Provider Demographics
NPI:1669797791
Name:LI, ZHONGZHEN (MD)
Entity type:Individual
Prefix:DR
First Name:ZHONGZHEN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3735
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:508-473-1210
Practice Address - Street 1:117 WATER ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3036
Practice Address - Country:US
Practice Address - Phone:508-478-4500
Practice Address - Fax:508-478-5235
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255318207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110096770AMedicaid
MA0034321201Medicare PIN