Provider Demographics
NPI:1194725531
Name:CHENG, SHENG-YEAN (PT)
Entity type:Individual
Prefix:
First Name:SHENG-YEAN
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4612 243RD ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1129
Mailing Address - Country:US
Mailing Address - Phone:917-640-4907
Mailing Address - Fax:
Practice Address - Street 1:13630 MAPLE AVE STE 2A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3869
Practice Address - Country:US
Practice Address - Phone:917-640-4907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ59731OtherBLUE CROSS BLUE SHIELD
NYQ59731OtherBLUE CROSS BLUE SHIELD