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General NPI Number Information
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NPI Number | 1124279013
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Entity Type | Organization
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Legal Business Name | PENG'S MEDICAL, P.C.
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 863 50TH ST M6
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City | BROOKLYN
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State | NY
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Zip | 11220-2417
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Country | US
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Telephone | 347-240-8482
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Fax | 347-295-1259
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Provider Business Mailing Address
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Address Line | 863 50TH ST M6
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City | BROOKLYN
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State | NY
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Zip | 11220-2417
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Country | US
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Telephone | 347-240-8482
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Fax | 347-295-1259
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JINPENG PENG
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Credential | MD
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Telephone | 347-240-8482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 233523
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License Number State | NY
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