Provider Demographics
NPI:1174849947
Name:PENG CONSULTING INC
Entity Type:Organization
Organization Name:PENG CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINZHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:PENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-220-0050
Mailing Address - Street 1:PO BOX 492
Mailing Address - Street 2:PO BOX 492
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-0492
Mailing Address - Country:US
Mailing Address - Phone:646-220-0050
Mailing Address - Fax:646-395-1911
Practice Address - Street 1:855 LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7631
Practice Address - Country:US
Practice Address - Phone:646-220-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222042-1207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02176685Medicaid