Provider Demographics
NPI:1821237520
Name:GENG, QINGDI (MD)
Entity Type:Individual
Prefix:
First Name:QINGDI
Middle Name:
Last Name:GENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2097 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 # 5
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:
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307979207R00000X
PAMD438773207R00000X
NJ25MA08629500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine