Provider Demographics
NPI:1467415554
Name:PANG, NORA W (RN)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:W
Last Name:PANG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 71ST AVE
Mailing Address - Street 2:APT. 308
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4553
Mailing Address - Country:US
Mailing Address - Phone:917-549-6187
Mailing Address - Fax:
Practice Address - Street 1:110-20 71ST AVENUE
Practice Address - Street 2:APT #308
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:917-549-6187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY493401-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse