Provider Demographics
NPI:1497794937
Name:CHENG, TUNG WOON (DPM)
Entity Type:Individual
Prefix:DR
First Name:TUNG
Middle Name:WOON
Last Name:CHENG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13907 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3342
Mailing Address - Country:US
Mailing Address - Phone:718-539-9001
Mailing Address - Fax:718-539-9173
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?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003223213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00633894Medicaid
NY00633894Medicaid
P34772Medicare ID - Type UnspecifiedEMPIRE MC ID
06702HMedicare ID - Type UnspecifiedGHI MC ID