Provider Demographics
NPI:1053532655
Name:ZHOU, DALAI (MD)
Entity type:Individual
Prefix:
First Name:DALAI
Middle Name:
Last Name:ZHOU
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 1:136-20 38TH AVE
Mailing Address - Street 2:SUITE 6C
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4233
Mailing Address - Country:US
Mailing Address - Phone:718-886-8299
Mailing Address - Fax:718-886-3669
Practice Address - Street 1:136-20 38TH AVE
Practice Address - Street 2:SUITE 6C
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-886-8299
Practice Address - Fax:718-886-3669
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246635207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2974289Medicaid
NY09601Medicare PIN