Provider Demographics
NPI:1730439399
Name:CHENG, ERIN CAROL (PA-C)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:CAROL
Last Name:CHENG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:CAROL
Other - Last Name:STRATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1181 E 120TH AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-5729
Mailing Address - Country:US
Mailing Address - Phone:303-673-1500
Mailing Address - Fax:303-689-6664
Practice Address - Street 1:1181 E 120TH AVE UNIT A
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-5729
Practice Address - Country:US
Practice Address - Phone:303-673-1500
Practice Address - Fax:303-689-6664
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0003518363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO14475341Medicaid
COCOA107119Medicare PIN