Provider Demographics
NPI:1134498397
Name:SUN, CHENG TUNG (NP)
Entity Type:Individual
Prefix:MR
First Name:CHENG
Middle Name:TUNG
Last Name:SUN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4137 149TH PL
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1017
Mailing Address - Country:US
Mailing Address - Phone:718-762-6727
Mailing Address - Fax:
Practice Address - Street 1:4137 149TH PL
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1017
Practice Address - Country:US
Practice Address - Phone:718-762-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-17
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY451418163W00000X
NY332973363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse