Provider Demographics
NPI:1710225909
Name:QIAO, FENGZHANG (LAC)
Entity type:Individual
Prefix:
First Name:FENGZHANG
Middle Name:
Last Name:QIAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 FT WASHINGTN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1248
Mailing Address - Country:US
Mailing Address - Phone:212-927-8039
Mailing Address - Fax:718-395-3247
Practice Address - Street 1:251 FT WASHINGTN AVE STE 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1248
Practice Address - Country:US
Practice Address - Phone:212-927-8039
Practice Address - Fax:718-395-3247
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000753171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist