Provider Demographics
NPI:1972657955
Name:CHENG, AMY S (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:S
Last Name:CHENG
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 1:20 WOODBINE ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-2025
Mailing Address - Country:US
Mailing Address - Phone:203-668-9523
Mailing Address - Fax:
Practice Address - Street 1:240 BRADLEY ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1108
Practice Address - Country:US
Practice Address - Phone:203-641-0038
Practice Address - Fax:203-773-1271
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002751103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical