Provider Demographics
NPI:1326546417
Name:CHENG, NGA YAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:NGA YAN
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3248 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1059
Mailing Address - Country:US
Mailing Address - Phone:347-632-7665
Mailing Address - Fax:
Practice Address - Street 1:13907 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3342
Practice Address - Country:US
Practice Address - Phone:718-539-9001
Practice Address - Fax:718-539-9173
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006914213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006914Medicaid