Provider Demographics
NPI:1366757429
Name:CHEUNG, PATRICK (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6837 KESSEL ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5729
Mailing Address - Country:US
Mailing Address - Phone:347-392-1783
Mailing Address - Fax:
Practice Address - Street 1:1 GUSSACK PLZ
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3256
Practice Address - Country:US
Practice Address - Phone:516-829-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist