Provider Demographics
NPI:1881659662
Name:CHENG, JIE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JIE
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2013
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03061-2013
Mailing Address - Country:US
Mailing Address - Phone:603-578-5090
Mailing Address - Fax:603-595-2997
Practice Address - Street 1:166 KINSLEY ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3676
Practice Address - Country:US
Practice Address - Phone:603-595-7371
Practice Address - Fax:603-595-6943
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11556208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203224Medicaid
NH30203224Medicaid
H70834Medicare UPIN