1861438236 NPI number — STANLEY NG MD PC

Table of content: (NPI 1861438236)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861438236 NPI number — STANLEY NG MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STANLEY NG MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861438236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
191 CANAL STREET
Provider Second Line Business Mailing Address:
SUITE 601
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-925-3224
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
191 CANAL STREET
Provider Second Line Business Practice Location Address:
SUITE 601
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-925-3224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TSANG
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
212-925-3224

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  163295 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00933275 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0411972 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 364AT1 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P765359 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2589330 . This is a "GHI" identifier . This identifiers is of the category "OTHER".