Healthcare Provider Details

I. General information

NPI: 1801862644
Provider Name (Legal Business Name): JENFU CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 HILL HOLLOW RD
WATCHUNG NJ
07069-6442
US

IV. Provider business mailing address

170 HILL HOLLOW RD
WATCHUNG NJ
07069-6442
US

V. Phone/Fax

Practice location:
  • Phone: 908-605-0259
  • Fax: 833-974-2499
Mailing address:
  • Phone: 908-605-0259
  • Fax: 833-974-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MA07604200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number25MA07604200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: