Provider Demographics
NPI:1184796716
Name:CHEUNG, NANE LAGHEZZA (MS, DC, DCBCN, PC)
Entity type:Individual
Prefix:DR
First Name:NANE
Middle Name:LAGHEZZA
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:MS, DC, DCBCN, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 KIRKLAND DR
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-2136
Mailing Address - Country:US
Mailing Address - Phone:212-949-3900
Mailing Address - Fax:866-556-5332
Practice Address - Street 1:25 CENTRAL PARK W
Practice Address - Street 2:STE. 1 F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7253
Practice Address - Country:US
Practice Address - Phone:212-949-3900
Practice Address - Fax:866-556-5332
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003722-1111N00000X
133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20441Medicare PIN
NY20441Medicare UPIN