Provider Demographics
NPI:1831281906
Name:CHENG, VIVIAN B (MD)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:B
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:185 CANAL ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4537
Mailing Address - Country:US
Mailing Address - Phone:212-343-7323
Mailing Address - Fax:212-343-7315
Practice Address - Street 1:185 CANAL ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4537
Practice Address - Country:US
Practice Address - Phone:212-343-7323
Practice Address - Fax:212-343-7315
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1159162080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY115916OtherLICENSE#