Provider Demographics
NPI:1215111794
Name:CHEONG, ELIZABETH SUNJU (MD PC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SUNJU
Last Name:CHEONG
Suffix:
Gender:F
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E. 65TH ST
Mailing Address - Street 2:#2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6512
Mailing Address - Country:US
Mailing Address - Phone:917-403-4110
Mailing Address - Fax:
Practice Address - Street 1:55 E. 65TH ST
Practice Address - Street 2:#2A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6512
Practice Address - Country:US
Practice Address - Phone:917-403-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193183207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice