Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 148760 | NY |
N | 207R00000X | Internist | 148760 | NY |
N | 111NI0900X | Internist | 148760 | NY |
NPI | 1124075577 |
---|---|
Provider Name | David Cheng |
First Address | Flushing, NY 11358-1735 |
Second Address | Flushing, NY 11358-1735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 30/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00745946 | (05) | NY |
C05698 | (02) |