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NPI Code Detail

MEDICARE: MINZHONG PENG M.D.

MEDICARE:   MINZHONG  PENG  M.D.
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
1174400000XSpecialistMA07665500NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508860834
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINZHONG PENG M.D.
Provider Business Mailing Address
First Line : PO BOX 492
Second Line :
City : MORRIS PLAINS
State : NJ
Zip : 07950-0492
Country : US
Telephone Number : 646-220-0050
Fax Number :
Provider Business Practice Location Address
First Line : 855 LEHIGH AVE
Second Line :
City : UNION
State : NJ
Zip : 07083-7631
Country : US
Telephone Number : 646-220-0050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/20/2012

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Directions to “ MINZHONG PENG M.D.” Practice Location

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