Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 60374 | CT |
NPI | 1013356716 |
---|---|
Provider Name | Dr. Derek Cheng |
First Address | Stamford, CT 06902-3602 |
Second Address | Stamford, CT 06902-3602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 24/02/2020 |