1356479596 NPI number — MS. ELLEN CHEUNG PT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356479596 NPI number — MS. ELLEN CHEUNG PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEUNG
Provider First Name:
ELLEN
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356479596
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
115 MAIN ST
Provider Second Line Business Mailing Address:
SUITE 202 2ND FLOOR
Provider Business Mailing Address City Name:
TUCKAHOE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10707-2948
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-961-1010
Provider Business Mailing Address Fax Number:
914-961-1011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 202 2ND FLOOR
Provider Business Practice Location Address City Name:
TUCKAHOE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10707-2948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-961-1010
Provider Business Practice Location Address Fax Number:
914-961-1011
Provider Enumeration Date:
03/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  0239991 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0401995 . This is a "CIGNA HEALTH PLANS-ORTHONET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Q622D1 . This is a "EMPIRE BC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0401995 . This is a "CIGNA- ORTHONET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 201116700038 . This is a "AFFINITY HEALTH PLAN(S) MEDICARE AND MEDICAID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 272438120 . This is a "HUDSON VALLEY HEALTH PLAN /GRP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 401995 . This is a "US FAMILY HEALTH-ORTHONET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7682673 . This is a "AETNA LOCAL 1199" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 841740 . This is a "OPTUM HEALTH-PHYSICAL THERAPY (PLANS)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 854487P . This is a "EMBLEM HEALTH PLANS AND HIP/GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P4162448 . This is a "OXFORD HEALTH/FREEDOM-OPTUMHEATLH CARE SOLUTIONS, INC." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 272438120 . This is a "VNS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P01164882 . This is a "MVP HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01829332 . This is a "AMERIGROUP PLAN(S) HEALTHY FHP NY MEDICARE BALANCE AND SPECIALTY NETWORKS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Q097Q1 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000218517110 . This is a "UNITED HEALTH CARE OPTUMHEALTH CARE SOLUTIONS, INC." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0401997 . This is a "CIGNA HEALTH PLANS-MCLEAN AVENUE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1251 . This is a "AMIDACARE-GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 272438120 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 616130500 . This is a "FECA/OFFICE OF WORKERS COMPENSATION PROGRAM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02397657 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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