Healthcare Provider Details

I. General information

NPI: 1881607588
Provider Name (Legal Business Name): HSINLIN T CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PARKMAN ST WACC835
BOSTON MA
02114-3117
US

IV. Provider business mailing address

15 PARKMAN ST WACC835
BOSTON MA
02114-3117
US

V. Phone/Fax

Practice location:
  • Phone: 617-643-8277
  • Fax: 617-724-0895
Mailing address:
  • Phone: 617-643-8277
  • Fax: 617-724-0895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301076957
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number4301076957
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number254227
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number254227
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: