Basic Information
Provider Information
NPI: 1861650665
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TSENG
FirstName: KENNETH
MiddleName: SHEINJE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3100 SPRING FOREST RD
Address2: SUITE 130
City: RALEIGH
State: NC
PostalCode: 276162880
CountryCode: US
TelephoneNumber: 9198827908
FaxNumber: 9198739821
Practice Location
Address1: 3300 GALLOWS RD
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220423307
CountryCode: US
TelephoneNumber: 7037763138
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/28/2008
LastUpdateDate: 09/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208VP0000X0101261177VAY Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine
207L00000X0101261177VAN Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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