Healthcare Provider Details

I. General information

NPI: 1942509625
Provider Name (Legal Business Name): LUCY CHENG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

947 LINWOOD AVE STE 2E
RIDGEWOOD NJ
07450
US

IV. Provider business mailing address

947 LINWOOD AVE STE 2E
RIDGEWOOD NJ
07450-2900
US

V. Phone/Fax

Practice location:
  • Phone: 201-447-6468
  • Fax: 201-447-3189
Mailing address:
  • Phone: 201-447-6468
  • Fax: 201-447-3189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA10256500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number274531
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: