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1780983007

NPI Code Detail

MEDICARE: FENG SU MD

MEDICARE: FENG SU MD

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
1	207RT0003X	Transplant Hepatology Physician	319564	NY
2	207RT0003X	Transplant Hepatology Physician	25MA11646800	NJ
3	207RT0003X	Transplant Hepatology Physician	0101271106	VA
4	207R00000X	Internal Medicine Physician	0101271106	VA
5	207RG0100X	Gastroenterology Physician	319564	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780983007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FENG SU MD

Provider Business Mailing Address
First Line	:	14 WALL ST FL 9
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10005-2178
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	317 E 34TH ST FL 8
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-4910
Country	:	US
Telephone Number	:	212-263-8134
Fax Number	:	212-263-8157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	05/03/2024

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Directions to “ FENG SU MD” Practice Location

Language	Start Address	Practice Location

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