Provider Demographics
NPI:1730314329
Name:CHEUNG, CHING YING VIVIAN
Entity Type:Individual
Prefix:
First Name:CHING YING VIVIAN
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195A SYOSSET WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4128 MAIN ST
Practice Address - Street 2:STORE #5
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3134
Practice Address - Country:US
Practice Address - Phone:917-886-8968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist