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NPI Code Detail

MEDICARE: JIE FENG

MEDICARE: JIE FENG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner26NJ15031300NJ

General Provider Information

NPI Number : 1770341984
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIE FENG
Provider Business Mailing Address
First Line : 5604 7TH AVE STE 1
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4660
Country : US
Telephone Number : 215-359-8890
Fax Number :
Provider Business Practice Location Address
First Line : 5604 7TH AVE STE 1
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4660
Country : US
Telephone Number : 215-359-8890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2024
Last Update Date : 05/04/2024

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