Provider Demographics
NPI:1609137710
Name:MABEL M.P. CHENG MD PLLC
Entity Type:Organization
Organization Name:MABEL M.P. CHENG MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-782-7777
Mailing Address - Street 1:3140 TROY SCHENECTADY RD
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-1719
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0521Medicare PIN