Provider Demographics
NPI:1538473202
Name:CHENG, BETHANY JOY (MPT)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:JOY
Last Name:CHENG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 VALENTINE AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5307
Mailing Address - Country:US
Mailing Address - Phone:626-616-0024
Mailing Address - Fax:
Practice Address - Street 1:33 VALENTINE AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5307
Practice Address - Country:US
Practice Address - Phone:626-616-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist