Provider Demographics
NPI:1710307939
Name:TENG, TINA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:
Last Name:TENG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9780 PYRAMID CT STE 260
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-7060
Mailing Address - Country:US
Mailing Address - Phone:720-420-1570
Mailing Address - Fax:
Practice Address - Street 1:9780 PYRAMID CT STE 260
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-7060
Practice Address - Country:US
Practice Address - Phone:720-420-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-27
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00332800363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant