Healthcare Provider Details

I. General information

NPI: 1144884719
Provider Name (Legal Business Name): AUSTIN VINCENT CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 JERICHO TPKE
MINEOLA NY
11501-1613
US

IV. Provider business mailing address

700 HICKSVILLE RD STE 205
BETHPAGE NY
11714-3472
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-4480
  • Fax: 516-663-6947
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number315739
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: