Provider Demographics
NPI:1184700452
Name:CHENG, CHRISTINE C (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
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 1:2311 CORPORAL KENNEDY ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1467
Mailing Address - Country:US
Mailing Address - Phone:718-696-4060
Mailing Address - Fax:718-231-1586
Practice Address - Street 1:MONTEFIORE SCHOOL HEALTH PROGRAM
Practice Address - Street 2:111 EAST 210TH STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-696-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016103103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist