Provider Demographics
NPI:1346486594
Name:MENG, GANG (MD)
Entity Type:Individual
Prefix:DR
First Name:GANG
Middle Name:
Last Name:MENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 8TH AVE UNIT 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3515
Mailing Address - Country:US
Mailing Address - Phone:646-683-0005
Mailing Address - Fax:718-633-8898
Practice Address - Street 1:5521 8TH AVE UNIT 4A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3515
Practice Address - Country:US
Practice Address - Phone:347-663-1255
Practice Address - Fax:718-633-8898
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250354208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03075418Medicaid