Individual
MISS DIANA PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
101 E OLNEY AVE, SUITE 400, PHILADELPHIA, PA 19120-2421
(215) 456-7000
(215) 254-2599
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053050
PA
Other
Enumeration date
10/05/2007
Last updated
11/22/2011
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