PENG PANG


Address: 101 Nicolls Rd, Stony Brook, NY 11794-8101
Phone: 6316898333

PENG PANG (NPI# 1174703359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174703359
Entity Type Individual
Full Name PENG PANG
Credential M.D.
Practice Address 101 Nicolls Rd
Stony Brook
NY 11794-8101
Practice Telephone 6316898333
Mailing Telephone 6316898333
Enumeration Date 2007-11-06
Last Update Date 2012-07-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
004071 NY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY NY STATE LICENSE 004071 01

Office Location

Street Address 101 NICOLLS RD
City STONY BROOK
State NY
Zip Code 11794-8101

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174511760 Monika Isabela Woroniecka Allergy & Immunology 101 Nicolls Rd, Stony Brook, NY 11794-0001 2005-10-08
1245830082 Dorothy E Gozdziak Registered Nurse 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-10-30
1366041907 Christine Morgan Registered Nurse 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-10-24
1235736240 Glenn Phillip Schiotis Jr. Pharmacist 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-10-02
1508470477 Tomas Liboreiro Nurse Practitioner 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-09-08
1881211266 Valerie Marie Birmingham Nurse Anesthetist, Certified Registered 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-07-01
1841816303 Richard S Menjivar General Acute Care Hospital 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-06-22
1801419528 Jamie Rachel Moore Registered Nurse 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-05-28
1871114108 Samantha Dunn Student in an Organized Health Care Education/Training Program 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-04-28
1750901294 Samantha Ann Morganelli Student in an Organized Health Care Education/Training Program 101 Nicolls Rd, Stony Brook, NY 11794-0001 2020-04-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619506714 Ryan John Kottmeier Physician Assistant 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 2020-04-02
1699302109 Michael Trentalange Student in an Organized Health Care Education/Training Program Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 2020-03-25
1164985156 Lauren Kate Harris Student in an Organized Health Care Education/Training Program Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 2019-04-08
1851851448 Kathy Tin Student in an Organized Health Care Education/Training Program Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 2019-03-21
1174083703 Arham Khan Student in an Organized Health Care Education/Training Program Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 2019-03-20
1396221982 Aman Bhojani Student in an Organized Health Care Education/Training Program Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 2018-07-17
1699265629 Belliny Phaeton Student in an Organized Health Care Education/Training Program Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 2018-05-15
1629568969 Rachel Herold Student in an Organized Health Care Education/Training Program Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 2018-05-11
1598254419 Nora Ann Diraimondo Nurse Practitioner Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 2018-05-07
1386140705 Ryan Christopher Corn Student in an Organized Health Care Education/Training Program Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 2018-04-04
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194119560 Krishen Persaud Psychiatry & Neurology Stony Brook Psychiatric Associates, Ufpc, Sbumc, Hsc Level 10, Rm.020, Stony Brook, NY 11794-8101 2015-03-24
1275779688 Jessica Jean Richter Psychiatry & Neurology Stony Brook Psychiatric Associates, Hsc Level 10 Room 020, Stony Brook, NY 11794-8101 2009-01-06
1003012436 Maged Sobhy Soliman Psychiatry & Neurology Child and Adolescent Psychiatry Outpatient Department, 169 Putnam Hall, Stony Brook, NY 11794 2007-06-22
1649697426 Amanda Gorecki Psychiatry & Neurology Putnam Hall South Campus, Stony Brook, NY 11794-8790 2014-03-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1093327611 Adel Mostafavi, Md PC Psychiatry & Neurology 104 W 40th St Rm 400, New York, NY 10018-3692 2020-08-17
1023632015 Child and Adult Clinical Psychiatry PC Psychiatry & Neurology 75 Prospect St Ste 110, Huntington, NY 11743-3320 2020-06-04
1598306441 Place of Mind Child, Adolescent, and Adult Psychiatry P.C. Psychiatry & Neurology 240 Central Park S Apt 2h, New York, NY 10019-1435 2019-10-02
1881102267 Park Avenue Physicians PC Psychiatry & Neurology 5 W 86th St Apt 1b, New York, NY 10024-3663 2018-01-19
1518478080 Diego G. Calabria Physician P.C. Psychiatry & Neurology 366 N Broadway Ste 304, Jericho, NY 11753-2000 2017-10-23
1013426865 Bebsy Estefan Md PC Psychiatry & Neurology 3050 Corlear Ave # Phb, Bronx, NY 10463-5180 2017-09-25
1902281629 Derek Rudge Psychiatry & Neurology 1051 Riverside Dr Rm 235, New York, NY 10032-1007 2015-07-23
1275918096 Dr Omar Bashayan Physician Pllc Psychiatry & Neurology 155 W 68th St Apt 1102, New York, NY 10023-5816 2015-07-22
1740676766 Maura E Tappen Psychiatry & Neurology 1860 South Ave, Rochester, NY 14620-4229 2015-04-07
1710389069 John F. Erhart Md PC Psychiatry & Neurology 85 Summit Dr, Rochester, NY 14620-3129 2014-09-18
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Competitor

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City STONY BROOK
Zip Code 11794

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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