Provider Demographics
NPI:1760012306
Name:CHEUNG, KATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 MARTENSE ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3234
Mailing Address - Country:US
Mailing Address - Phone:516-376-3244
Mailing Address - Fax:
Practice Address - Street 1:46 COOPER SQ
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-7119
Practice Address - Country:US
Practice Address - Phone:516-321-0989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022659103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist