Provider Demographics
NPI:1649337122
Name:LAN, FENGSHUO (MD,PHD)
Entity type:Individual
Prefix:DR
First Name:FENGSHUO
Middle Name:
Last Name:LAN
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONY BROOK UNIVERSITY CANCER CTR
Mailing Address - Street 2:3 EDMUND D. PELLEGRINO ROAD
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-638-1000
Mailing Address - Fax:631-444-0915
Practice Address - Street 1:STONY BROOK UNIVERSITY CANCER CTR
Practice Address - Street 2:3 EDMUND D. PELLEGRINO ROAD
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-638-1000
Practice Address - Fax:631-444-0915
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY233819174400000X, 207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine