MEDICARE: MR. CHENG FENG ZHENG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171WV0202X	Vehicle Modifications Contractor	B01721	NY

General Provider Information

NPI Number	:	1386981751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHENG FENG ZHENG

Provider Business Mailing Address
First Line	:	108 MADISON ST
Second Line	:	STORE FRONT
City	:	NEW YORK
State	:	NY
Zip	:	10002-7213
Country	:	US
Telephone Number	:	212-274-1166
Fax Number	:	212-219-0443

Provider Business Practice Location Address
First Line	:	108 MADISON ST
Second Line	:	STORE FRONT
City	:	NEW YORK
State	:	NY
Zip	:	10002-7213
Country	:	US
Telephone Number	:	212-274-1166
Fax Number	:	212-219-0443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2013
Last Update Date	:	01/05/2013

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