Provider Demographics
NPI:1326149576
Name:CHAN-TING, RENGENA E (DO)
Entity Type:Individual
Prefix:DR
First Name:RENGENA
Middle Name:E
Last Name:CHAN-TING
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2475 MCCLELLAN AVE
Mailing Address - Street 2:BUILDING C
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-4683
Mailing Address - Country:US
Mailing Address - Phone:856-675-3355
Mailing Address - Fax:856-675-3686
Practice Address - Street 1:2475 MCCLELLAN AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4683
Practice Address - Country:US
Practice Address - Phone:856-675-3355
Practice Address - Fax:856-675-3686
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9575207R00000X
NY223728207RG0300X
NJ25MB08786100207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6755ZMedicare UPIN