Provider Demographics
NPI:1508329160
Name:CHEUNG, OPHELIA (PA)
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 YORK AVE APT 22A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8794
Mailing Address - Country:US
Mailing Address - Phone:954-326-8313
Mailing Address - Fax:
Practice Address - Street 1:6230 REESE RD APT 315
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-1273
Practice Address - Country:US
Practice Address - Phone:954-326-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant