Provider Demographics
NPI:1164491171
Name:NG, NIK G (MD)
Entity Type:Individual
Prefix:DR
First Name:NIK
Middle Name:G
Last Name:NG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NIK
Other - Middle Name:GRATITUDE
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2 CATHARINE STREET, P.O. BOX 550
Mailing Address - Street 2:EAST MANHATTAN ANESTHESIA PARTNERS, LLC
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12602
Mailing Address - Country:US
Mailing Address - Phone:866-868-8415
Mailing Address - Fax:845-790-2675
Practice Address - Street 1:310 E 14TH STREET
Practice Address - Street 2:NY EYE & EAR INFIRMARY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-979-4464
Practice Address - Fax:773-583-4295
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267815-1NY207L00000X
CAA96718207L00000X, 207LC0200X, 207R00000X
NY267815207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A967180Medicaid
CAI35670Medicare UPIN
CAAY116YMedicare PIN
CAAP821ZMedicare PIN