Provider Demographics
NPI:1164547402
Name:DENG, JULIANG (MD)
Entity Type:Individual
Prefix:
First Name:JULIANG
Middle Name:
Last Name:DENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 STERLING CT
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2420
Mailing Address - Country:US
Mailing Address - Phone:516-802-2343
Mailing Address - Fax:718-463-2197
Practice Address - Street 1:4202 KISSENA BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3214
Practice Address - Country:US
Practice Address - Phone:718-428-8699
Practice Address - Fax:718-463-2197
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200689207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY200689OtherHIP
NY20068901OtherNEIGHBORHOOD
NY4C5040OtherPHS
NY0100694OtherAMERICHOICE
NY292811OtherWELLCARE
NY402392OtherUNITED HEALTHCARE
NY117901OtherELDERPLAN
NY912380OtherAETNA
NY01837512Medicaid
NY432396NHOtherCIGNA
NYJD07633610OtherBCBS
NY010200689NY01OtherANTHEM HEALTH NETWORK
NYP451081OtherOXFORD INSURANCE
NY200689-A45Other1199 NATIONAL BENEFIT FUN
NY2595031OtherGHI
NYP451081OtherOXFORD INSURANCE
NY200689OtherHIP