Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS9575 | FL |
N | 111NI0900X | Internist | OS9575 | FL |
N | 207RG0300X | Geriatric Medicine | 223728 | NY |
Y | 207RH0002X | Hospice and Palliative Medicine | 25MB08786100 | NJ |
NPI | 1326149576 |
---|---|
Provider Name | Dr. Rengena E. Chan-Ting |
First Address | Pennsauken, NJ 08109-4683 |
Second Address | Pennsauken, NJ 08109-4683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 09/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U6755Z | (02) | FL |