Provider Demographics
NPI:1023582319
Name:CHEUNG, STEPHANIE L (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11114 GREINER RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-2602
Mailing Address - Country:US
Mailing Address - Phone:267-575-3569
Mailing Address - Fax:
Practice Address - Street 1:7941 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2224
Practice Address - Country:US
Practice Address - Phone:215-745-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist