Provider Demographics
NPI:1568910495
Name:GENG, MD, LLC
Entity Type:Organization
Organization Name:GENG, MD, LLC
Other - Org Name:MEDICAL ACUCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:QINGDI
Authorized Official - Middle Name:
Authorized Official - Last Name:GENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-216-6938
Mailing Address - Street 1:2097 KLOCKNER RD BLDG 5
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3416
Mailing Address - Country:US
Mailing Address - Phone:609-216-6938
Mailing Address - Fax:
Practice Address - Street 1:2097 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3416
Practice Address - Country:US
Practice Address - Phone:609-216-6938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08629500261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty