Provider Demographics
NPI:1407054380
Name:NG, JEREMY TUCK WOH (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:TUCK WOH
Last Name:NG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:THE WANAMAKE BLDG. 9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9538
Mailing Address - Fax:267-425-9552
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:THE CHILDREN'S HOSPITAL OF PHILADELPHI
Practice Address - City:PHILADELHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-590-1572
Practice Address - Fax:215-590-1501
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2014-11-13
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Provider Licenses
StateLicense IDTaxonomies
FLME113644207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG0443ZOtherMEDICARE PTAN