Healthcare Provider Details

I. General information

NPI: 1124075577
Provider Name (Legal Business Name): DAVID CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 12/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16804 35TH AVE
FLUSHING NY
11358-1735
US

IV. Provider business mailing address

16804 35TH AVE
FLUSHING NY
11358-1735
US

V. Phone/Fax

Practice location:
  • Phone: 718-353-6203
  • Fax:
Mailing address:
  • Phone: 718-353-6203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number148760
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number148760
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00745946
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: