Provider Demographics
NPI:1558784165
Name:CHENG, MERRY (MSED)
Entity Type:Individual
Prefix:
First Name:MERRY
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24927 THEBES AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1335
Mailing Address - Country:US
Mailing Address - Phone:917-217-7020
Mailing Address - Fax:
Practice Address - Street 1:24927 THEBES AVE
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1335
Practice Address - Country:US
Practice Address - Phone:917-217-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY819230141174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist