MEDICARE: TIFFANY CHEUNG DO

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	208600000X	Surgery Physician	34017032	OH
2	2086X0206X	Surgical Oncology Physician	34017032	OH
3	208600000X	Surgery Physician	279283	MA
4	208600000X	Surgery Physician	25MB12855600	NJ

General Provider Information

NPI Number	:	1972066702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY CHEUNG DO

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-4124
Country	:	US
Telephone Number	:	207-590-5916
Fax Number	:

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

Provider Enumeration Date	:	04/09/2019
Last Update Date	:	01/26/2026

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Directions to “ TIFFANY CHEUNG DO” Practice Location

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