Provider Demographics
NPI:1790091445
Name:CHENG, MELINDA (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 GORE ST
Mailing Address - Street 2:#2
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1239
Mailing Address - Country:US
Mailing Address - Phone:617-871-6127
Mailing Address - Fax:
Practice Address - Street 1:14 MCGRATH HWY
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4505
Practice Address - Country:US
Practice Address - Phone:617-776-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist