Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 275128 | NY |
NPI | 1013235340 |
---|---|
Provider Name | Xiangmin Peng |
First Address | Middletown, NY 10941-4028 |
Second Address | West Nyack, NY 10994-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2010 |
Last Update Date | 13/10/2020 |