Provider Demographics
NPI:1689645475
Name:CHENG, SHU-CHUNG SHIH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHU-CHUNG
Middle Name:SHIH
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 1:29 FENIMORE RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-2250
Mailing Address - Country:US
Mailing Address - Phone:914-725-0009
Mailing Address - Fax:914-725-0009
Practice Address - Street 1:2094 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3509
Practice Address - Country:US
Practice Address - Phone:718-240-0480
Practice Address - Fax:718-240-0564
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135105208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG61422Medicare UPIN
NY545601Medicare ID - Type Unspecified