Provider Demographics
NPI:1164026431
Name:CHENG, PEIPEI
Entity Type:Individual
Prefix:
First Name:PEIPEI
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1515
Mailing Address - Country:US
Mailing Address - Phone:781-308-5773
Mailing Address - Fax:
Practice Address - Street 1:42 BEALE ST
Practice Address - Street 2:
Practice Address - City:WOLLASTON
Practice Address - State:MA
Practice Address - Zip Code:02170-2617
Practice Address - Country:US
Practice Address - Phone:617-471-7451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist