Healthcare Provider Details

I. General information

NPI: 1124013230
Provider Name (Legal Business Name): YE CHENG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/02/2020
Certification Date: 07/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5717 7TH AVE FL 1
BROOKLYN NY
11220-3902
US

IV. Provider business mailing address

1565 84TH ST
BROOKLYN NY
11228-3131
US

V. Phone/Fax

Practice location:
  • Phone: 718-492-2008
  • Fax: 718-492-2003
Mailing address:
  • Phone: 718-492-2008
  • Fax: 718-492-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number229800
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: