Provider Demographics
NPI:1407953649
Name:NG, ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALAN
Other - Middle Name:
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8611 JUSTICE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4555
Mailing Address - Country:US
Mailing Address - Phone:347-242-3387
Mailing Address - Fax:347-242-3386
Practice Address - Street 1:8611 JUSTICE AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4555
Practice Address - Country:US
Practice Address - Phone:347-242-3387
Practice Address - Fax:347-242-3386
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219706208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02358510Medicaid
NY05599Medicare PIN
NY02358510Medicaid