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General NPI Number Information
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NPI Number | 1518421478
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Entity Type | Organization
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Legal Business Name | ELISA K. CHENG, MD LLC
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 20 WILLARD ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-4861
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Country | US
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Telephone | 617-855-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 24 DEAN ST
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City | BELMONT
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State | MA
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Zip | 02478-3257
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Country | US
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Telephone | 617-312-3339
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Fax | 219-209-5667
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELISA CHENG
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Credential | MD
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Telephone | 617-312-3339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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