Healthcare Provider Details

I. General information

NPI: 1083000640
Provider Name (Legal Business Name): YAN YEE CHENG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 MOTT ST STE 602
NEW YORK NY
10013-5589
US

IV. Provider business mailing address

128 MOTT ST STE 602
NEW YORK NY
10013-5589
US

V. Phone/Fax

Practice location:
  • Phone: 212-796-7088
  • Fax:
Mailing address:
  • Phone: 212-796-7088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA164958
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number302523-01
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA164958
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: