Individual
DR. JENNIFER LYNN PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(646) 929-7870
Mailing address
111 BROADWAY, NEW YORK, NY 10006-1901
(212) 263-9700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
323004-01
NY
207RG0100X
Gastroenterology Physician
Primary
323004
NY
390200000X
Student in an Organized Health Care Education/Training Program
11019416A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11019416A
IPLA
IN
Enumeration date
06/21/2017
Last updated
12/18/2023
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