Provider Demographics
NPI:1639589666
Name:CHENG, ADONIS (DO)
Entity Type:Individual
Prefix:MR
First Name:ADONIS
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:DO
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 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:100 COMMERCE PL
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1302
Practice Address - Country:US
Practice Address - Phone:973-829-4632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2021-09-10
Deactivation Date:2014-07-15
Deactivation Code:
Reactivation Date:2018-04-16
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11131500207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine