MEDICARE: TIMOTHY CHEUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	196209	NY

General Provider Information

NPI Number	:	1659301802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY CHEUNG

Provider Business Mailing Address
First Line	:	9017 24TH RD
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11369-1110
Country	:	US
Telephone Number	:	718-839-3466
Fax Number	:

Provider Business Practice Location Address
First Line	:	9017 24TH RD
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11369-1110
Country	:	US
Telephone Number	:	718-839-3466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	10/03/2007

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Directions to “ TIMOTHY CHEUNG ” Practice Location

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