Provider Demographics
NPI:1174181713
Name:DENG, ZHEN (RD)
Entity Type:Individual
Prefix:MS
First Name:ZHEN
Middle Name:
Last Name:DENG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 BAY RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4629
Mailing Address - Country:US
Mailing Address - Phone:646-875-1655
Mailing Address - Fax:
Practice Address - Street 1:2054 BAY RIDGE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4629
Practice Address - Country:US
Practice Address - Phone:646-875-1655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86034582133V00000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY008568OtherTHE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT
86034582OtherCOMMISSION ON DIETETIC REGISTRATION