Provider Demographics
NPI:1023291531
Name:TENG, JESSICA (RPH)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:
Last Name:TENG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5771
Mailing Address - Country:US
Mailing Address - Phone:212-794-7200
Mailing Address - Fax:212-794-7230
Practice Address - Street 1:931 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5771
Practice Address - Country:US
Practice Address - Phone:212-794-7200
Practice Address - Fax:212-794-7230
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046088-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist