Provider Demographics
NPI:1568595528
Name:ZHENG, JEAN QINGJUN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:QINGJUN
Last Name:ZHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:QINGJUN
Other - Middle Name:
Other - Last Name:ZHENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:196 CANAL ST
Mailing Address - Street 2:5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4562
Mailing Address - Country:US
Mailing Address - Phone:212-608-2867
Mailing Address - Fax:212-566-4689
Practice Address - Street 1:196 CANAL ST
Practice Address - Street 2:5B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4562
Practice Address - Country:US
Practice Address - Phone:212-608-2867
Practice Address - Fax:212-566-4689
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224016208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY224016OtherNYS LICENSE