Provider Demographics
NPI:1245380112
Name:CHEUNG, MAN SING
Entity Type:Individual
Prefix:
First Name:MAN SING
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 54TH ST
Mailing Address - Street 2:GROUND FL.
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3208
Mailing Address - Country:US
Mailing Address - Phone:718-435-4647
Mailing Address - Fax:
Practice Address - Street 1:819 54TH ST
Practice Address - Street 2:GROUND FL.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3208
Practice Address - Country:US
Practice Address - Phone:718-435-4647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042998122300000X
NY041879-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist