Healthcare Provider Details

I. General information

NPI: 1144183666
Provider Name (Legal Business Name): FIRST STREAMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 LYNDALE AVE
STATEN ISLAND NY
10312-5037
US

IV. Provider business mailing address

85 LYNDALE AVE
STATEN ISLAND NY
10312-5037
US

V. Phone/Fax

Practice location:
  • Phone: 929-228-8503
  • Fax:
Mailing address:
  • Phone: 929-228-8503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. WING MAN CHENG
Title or Position: OWNER
Credential:
Phone: 929-228-8503