Healthcare Provider Details

I. General information

NPI: 1801455357
Provider Name (Legal Business Name): IRENE CHEUNG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2019
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 OLD COUNTRY RD
PLAINVIEW NY
11803-6502
US

IV. Provider business mailing address

522 OLD COUNTRY RD
PLAINVIEW NY
11803-6502
US

V. Phone/Fax

Practice location:
  • Phone: 516-513-0616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number316436
License Number StateNY

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: