Healthcare Provider Details

I. General information

NPI: 1114906690
Provider Name (Legal Business Name): YIPING GENG M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13304 41ST AVE FIRST FLOOR-A
FLUSHING NY
11355-3629
US

IV. Provider business mailing address

13304 41ST AVE FIRST FLOOR-A
FLUSHING NY
11355-3629
US

V. Phone/Fax

Practice location:
  • Phone: 718-353-7265
  • Fax: 718-353-7267
Mailing address:
  • Phone: 718-353-7265
  • Fax: 718-353-7267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number221887
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number221887
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: