Provider Demographics
NPI:1376169888
Name:CHENG, TIFFANY (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MEREDITH RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2245
Mailing Address - Country:US
Mailing Address - Phone:732-543-5971
Mailing Address - Fax:
Practice Address - Street 1:603 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2601
Practice Address - Country:US
Practice Address - Phone:800-242-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04002000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI04002000OtherNEW JERSEY BOARD OF PHARMACY