Provider Demographics
NPI:1447290291
Name:TU, JIANGLING JENNY (MD)
Entity type:Individual
Prefix:DR
First Name:JIANGLING
Middle Name:JENNY
Last Name:TU
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 1:100 CHARLES LINDBERGH BLVD
Mailing Address - Street 2:BOSTWICK LABORATORIES
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3631
Mailing Address - Country:US
Mailing Address - Phone:516-512-5200
Mailing Address - Fax:516-512-5301
Practice Address - Street 1:100 CHARLES LINDBERGH BLVD
Practice Address - Street 2:BOSTWICK LABORATORIES
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3631
Practice Address - Country:US
Practice Address - Phone:516-512-5200
Practice Address - Fax:516-512-5301
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221529174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50R561Medicare ID - Type Unspecified