Provider Demographics
NPI:1851834741
Name:FENG, SERENE
Entity Type:Individual
Prefix:
First Name:SERENE
Middle Name:
Last Name:FENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14307 SANFORD AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2001
Mailing Address - Country:US
Mailing Address - Phone:646-651-6338
Mailing Address - Fax:
Practice Address - Street 1:14307 SANFORD AVE APT 1A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2001
Practice Address - Country:US
Practice Address - Phone:718-888-9087
Practice Address - Fax:917-634-8851
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-23
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005649171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist