MEDICARE: VIVIAN CHENG

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	183500000X	Pharmacist	046820	NY

General Provider Information

NPI Number	:	1861812687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN CHENG

Provider Business Mailing Address
First Line	:	10255 67TH RD APT 5Z
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2648
Country	:	US
Telephone Number	:	917-847-9175
Fax Number	:

Provider Business Practice Location Address
First Line	:	10255 67TH RD APT 5Z
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2648
Country	:	US
Telephone Number	:	917-847-9175
Fax Number	:

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

Provider Enumeration Date	:	04/19/2014
Last Update Date	:	04/19/2014

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Directions to “ VIVIAN CHENG ” Practice Location

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