Healthcare Provider Details

I. General information

NPI: 1720739402
Provider Name (Legal Business Name): TELEHEALTH MEDICAL SERVICES OF KS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E DOUGLAS AVE FL 2
WICHITA KS
67202-3548
US

IV. Provider business mailing address

228 PARK AVE SOUTH, PMB 31583
NEW YORK NY
10003-1502
US

V. Phone/Fax

Practice location:
  • Phone: 844-301-0093
  • Fax:
Mailing address:
  • Phone: 844-310-0093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AIDEN FENG
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 844-301-0093