Healthcare Provider Details

I. General information

NPI: 1417151341
Provider Name (Legal Business Name): ALICE VAN-HENG CHEUK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W KINGSBRIDGE RD DEPARTMENT OF RADIATION ONCOLOGY, GD-02
BRONX NY
10468-3904
US

IV. Provider business mailing address

130 W KINGSBRIDGE RD DEPARTMENT OF RADIATION ONCOLOGY, GD-02
BRONX NY
10468-3904
US

V. Phone/Fax

Practice location:
  • Phone: 718-741-4226
  • Fax: 718-741-4684
Mailing address:
  • Phone: 718-741-4226
  • Fax: 718-741-4684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA93264
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number253777
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: