Provider Demographics
NPI:1902072788
Name:FENG, ANDREA (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:FENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 CENTRE ST
Mailing Address - Street 2:SUITE 802
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4408
Mailing Address - Country:US
Mailing Address - Phone:212-729-0391
Mailing Address - Fax:
Practice Address - Street 1:139 CENTRE ST
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4408
Practice Address - Country:US
Practice Address - Phone:212-729-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253513207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease