Individual
BENNIE H JENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 CIVIC CENTE BLVD, PHILADELPHIA, PA 19104
(667) 214-1232
Mailing address
3400 CIVIC CENTE BLVD, PHILADELPHIA, PA 19104
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35082112J
OH
207W00000X
Ophthalmology Physician
A79800
CA
207W00000X
Ophthalmology Physician
D76471
MD
207W00000X
Ophthalmology Physician
Primary
MD478378
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114512600
—
MD
05
—
2423505
—
OH
Enumeration date
06/24/2006
Last updated
11/09/2022
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