=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659860260
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JIPING ZENG MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2018
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 222 E 41ST ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10017-6739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-825-6300
-----------------------------------------------------
Fax | 646-825-6399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 HICKSVILLE RD STE 205
-----------------------------------------------------
City | BETHPAGE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11714-3472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-339-7843
-----------------------------------------------------
Fax | 212-263-4539
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | 01089903A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | R76823
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------