Healthcare Provider Details

I. General information

NPI: 1477498921
Provider Name (Legal Business Name): MELISSA CHEUNG NP
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HANSON PL APT 11A
BROOKLYN NY
11243-2903
US

IV. Provider business mailing address

1 HANSON PL APT 11A
BROOKLYN NY
11243-2903
US

V. Phone/Fax

Practice location:
  • Phone: 408-476-0106
  • Fax:
Mailing address:
  • Phone: 408-476-0106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number433219
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: