Healthcare Provider Details

I. General information

NPI: 1679491682
Provider Name (Legal Business Name): TIFFANY TIN-YUE CHEUNG OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 BROADWAY
NEW YORK NY
10025-7846
US

IV. Provider business mailing address

240 W 73RD ST APT 1110
NEW YORK NY
10023-2793
US

V. Phone/Fax

Practice location:
  • Phone: 929-822-4165
  • Fax:
Mailing address:
  • Phone: 857-706-9834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011402
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: