Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 010780 | NY |
NPI | 1003911538 |
---|---|
Provider Name | Kelly Cheng |
First Address | Elmhurst, NY 11373-1329 |
Second Address | Elmhurst, NY 11373-1329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 27/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q66055 | (02) | NY |