Provider Demographics
NPI:1427011667
Name:NG, EVA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:NG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8318 4TH AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4413
Mailing Address - Country:US
Mailing Address - Phone:718-333-5500
Mailing Address - Fax:
Practice Address - Street 1:8318 4TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4413
Practice Address - Country:US
Practice Address - Phone:718-333-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014422103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV022N2Medicare ID - Type Unspecified
NYP30651Medicare UPIN