Basic Information
| Provider Information | |||||||||
| NPI: | 1235580085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHENG | ||||||||
| FirstName: | LUCY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 WILLOUGHBY ST | ||||||||
| Address2: | APARTMENT 10V | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112014928 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4016 OLD WILLIAM PENN HWY | ||||||||
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| City: | MURRYSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156681823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247337544 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2016 | ||||||||
| LastUpdateDate: | 07/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | MD469901 | PA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.