Healthcare Provider Details

I. General information

NPI: 1952591760
Provider Name (Legal Business Name): BOWEN TZENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 04/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 FOREST AVE
PARAMUS NJ
07652-5325
US

IV. Provider business mailing address

195 FOREST AVE
PARAMUS NJ
07652-5325
US

V. Phone/Fax

Practice location:
  • Phone: 201-261-0379
  • Fax:
Mailing address:
  • Phone: 201-261-0379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA08289300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: