Provider Demographics
NPI:1740781517
Name:CHENG, KRISTIN DIANE CHIU MAE (LMT, LAC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:DIANE CHIU MAE
Last Name:CHENG
Suffix:
Gender:F
Credentials:LMT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 W 14TH ST. SUITE 502
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7403
Mailing Address - Country:US
Mailing Address - Phone:646-255-1332
Mailing Address - Fax:
Practice Address - Street 1:39 W 14TH ST. SUITE 502
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7403
Practice Address - Country:US
Practice Address - Phone:646-255-1332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005639171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist