Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 165672 | NY |
NPI | 1760452288 |
---|---|
Provider Name | Dr. Andrew T Cheng |
First Address | New York, NY 10013-4116 |
Second Address | New York, NY 10013-4116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 30/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00945639 | (05) | NY |
A63687 | (02) |