Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 25MAO09884900 | NJ |
NPI | 1003177676 |
---|---|
Provider Name | Jing Jing Feng |
First Address | Paterson, NJ 07514-1526 |
Second Address | Paterson, NJ 07514-1526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2012 |
Last Update Date | 18/11/2020 |