Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 217857 | NY |
Y | 2086S0127X | Trauma Surgeon | 217857 | NY |
NPI | 1114953908 |
---|---|
Provider Name | Dr. Julius David Cheng |
First Address | Rochester, NY 14642-8410 |
Second Address | Rochester, NY 14642-8410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 09/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02103184 | (05) | NY |
G98308 | (02) |