Provider Demographics
NPI:1174532402
Name:NIU, JING (MD)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:
Last Name:NIU
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 1:266 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1625
Mailing Address - Country:US
Mailing Address - Phone:732-218-9428
Mailing Address - Fax:
Practice Address - Street 1:1100 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4152
Practice Address - Country:US
Practice Address - Phone:732-981-1111
Practice Address - Fax:732-981-1113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07973500207R00000X
NY60237666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine