Chung J Peng, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

25MA04344900 Issued in NJ

Practice address

1 Blackberry LN
North Caldwell, NJ 07006-4170

Phone

(973) 429-6852

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902938988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACKBERRY LN",
            "city": "NORTH CALDWELL",
            "state": "NJ",
            "postal_code": "070064170",
            "telephone_number": "973-429-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACKBERRY LN",
            "city": "NORTH CALDWELL",
            "state": "NJ",
            "postal_code": "070064170",
            "telephone_number": "973-429-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "CHUNG",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "25MA04344900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1352407",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omnisurgical Partners, LLC
• Allison Osur
• Ashley Papapetrou, DO
• Michael Nicolae Pavel, P.T.
• Henry Pelzman, M.D.
• Jennifer Lynn Rhodes, MSN, FNP
• Stephanie J Rosen, PA-C
• Mark Vincent Russo, D.C.
• Andrea Sanderson, P.T.
• Carmela Sansone, PHD

• Neonatal-Perinatal Medicine Physician in North Caldwell, NJ
• Providers in North Caldwell, NJ by specialty
• Neonatal-Perinatal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.