Provider Demographics
NPI:1205022993
Name:ENG, SUSAN (LAC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:ENG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 6TH AVE
Mailing Address - Street 2:SUITE 1108
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3507
Mailing Address - Country:US
Mailing Address - Phone:212-868-5850
Mailing Address - Fax:212-967-5996
Practice Address - Street 1:875 6TH AVE
Practice Address - Street 2:SUITE 1108
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3507
Practice Address - Country:US
Practice Address - Phone:212-868-5850
Practice Address - Fax:212-967-5996
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist