Provider Demographics
NPI:1720022064
Name:ZHENG, PEISHU (MD)
Entity Type:Individual
Prefix:
First Name:PEISHU
Middle Name:
Last Name:ZHENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 ASPEN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1013
Mailing Address - Country:US
Mailing Address - Phone:610-328-2991
Mailing Address - Fax:610-328-2991
Practice Address - Street 1:1308 S 8TH STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-5716
Practice Address - Country:US
Practice Address - Phone:215-755-4534
Practice Address - Fax:215-755-4524
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053459L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010609640002Medicaid
PA096393Medicare ID - Type Unspecified
G61613Medicare UPIN