Provider Demographics
NPI:1558345306
Name:CHENG, MABEL MP (MD)
Entity Type:Individual
Prefix:DR
First Name:MABEL
Middle Name:MP
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9177
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-0177
Mailing Address - Country:US
Mailing Address - Phone:518-782-7777
Mailing Address - Fax:518-782-4913
Practice Address - Street 1:3140 TROY SCHENECTADY RD
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-1719
Practice Address - Country:US
Practice Address - Phone:518-782-7777
Practice Address - Fax:518-782-4913
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1690871207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01277389Medicaid
NY180045792OtherRAILROAD MEDICARE
NY01277389Medicaid