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General NPI Number Information
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NPI Number | 1861627887
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Entity Type | Organization
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Legal Business Name | JING DENG MD REHABILITATION,PC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 32 E BROADWAY RM 502
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City | NEW YORK
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State | NY
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Zip | 10002-6891
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Country | US
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Telephone | 212-925-8839
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Fax | 212-226-8498
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Provider Business Mailing Address
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Address Line | 800 2ND AVE # 610
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City | NEW YORK
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State | NY
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Zip | 10017-4709
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Country | US
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Telephone | 212-883-8898
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Fax | 212-883-6603
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Authorized Official
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Title or Position | PRESIDENT
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Name | JING DENG
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Credential | MD
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Telephone | 212-365-8989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 212380
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License Number State | NY
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