Provider Demographics
NPI:1285084194
Name:CHENG, TAO FEN (FNP)
Entity type:Individual
Prefix:
First Name:TAO FEN
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 MAIN ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4235 MAIN ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3956
Practice Address - Country:US
Practice Address - Phone:718-886-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily