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General NPI Number Information
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NPI Number | 1265792501
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Entity Type | Individual
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Provider Name | LEI PENG M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 8081 INNOVATION PARK DR STE 765
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City | FAIRFAX
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State | VA
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Zip | 22031-4867
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Country | US
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Telephone | 571-472-1717
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Fax | 571-472-1718
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-6423
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Fax | 410-500-4266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | D84351
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | D84351
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 0101281832
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License Number State | VA
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