Provider Demographics
NPI:1992969109
Name:LAW, CHEUNG G (OD)
Entity type:Individual
Prefix:
First Name:CHEUNG
Middle Name:G
Last Name:LAW
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:201 LEHIGH VALLEY MALL
Mailing Address - Street 2:PEARLE VISION
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5719
Mailing Address - Country:US
Mailing Address - Phone:610-264-8537
Mailing Address - Fax:610-264-8417
Practice Address - Street 1:201 LEHIGH VALLEY MALL
Practice Address - Street 2:PEARLE VISION
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5719
Practice Address - Country:US
Practice Address - Phone:610-264-8537
Practice Address - Fax:610-264-8417
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002071152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA182345Q1AMedicare PIN