Provider Demographics
NPI:1871574160
Name:CHEUNG, YVONNE YINGWAI (MD)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:YINGWAI
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2451
Mailing Address - Country:US
Mailing Address - Phone:617-489-2499
Mailing Address - Fax:
Practice Address - Street 1:30 CLARK ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2451
Practice Address - Country:US
Practice Address - Phone:617-489-2499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76527207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3148114OtherMASS HEALTH
MAJ31742OtherBLUE SHIELD
MA754180OtherTUFTS
MA050081612OtherTRAVELERS/RAILROAD MEDICA
MA275008OtherHARVARD PILGRIM
MA30201737OtherNEW HAMPSHIRE MEDICAID
MA30490OtherCHILDREN'S MEDICAL SECURI
MA30490OtherHEALTHY START
MA30490OtherCOMMONWEALTH INDEMNITY (G
MAYC40954OtherRHODE ISLAND MEDICAID
MAG22279Medicare UPIN
MAM20745Medicare PIN
MA275008OtherHARVARD PILGRIM