Provider Demographics
NPI:1871806810
Name:CHENG, CECILIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:CECILIA
Other - Middle Name:
Other - Last Name:CHENG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:40 FURLONG DR
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4006
Mailing Address - Country:US
Mailing Address - Phone:781-485-0080
Mailing Address - Fax:
Practice Address - Street 1:40 FURLONG DR
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4006
Practice Address - Country:US
Practice Address - Phone:781-485-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH25784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist