Provider Demographics
NPI:1902869985
Name:CHU CHEONG, KEITH FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:FRANCIS
Last Name:CHU CHEONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:374 STOCKHOLM ST
Mailing Address - Street 2:C/O FACULTY PRACTICE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4006
Mailing Address - Country:US
Mailing Address - Phone:718-963-6551
Mailing Address - Fax:718-963-6793
Practice Address - Street 1:374 STOCKHOLM ST
Practice Address - Street 2:C/O FACULTY PRACTICE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4006
Practice Address - Country:US
Practice Address - Phone:718-963-6551
Practice Address - Fax:718-963-6793
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2473842084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02379037Medicaid
NYH90583Medicare UPIN
NY02379037Medicaid