Provider Demographics
NPI:1467623041
Name:NG-LO, ALICE
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:
Last Name:NG-LO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CARTERET RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2602
Mailing Address - Country:US
Mailing Address - Phone:973-994-1781
Mailing Address - Fax:
Practice Address - Street 1:41 E 58TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1617
Practice Address - Country:US
Practice Address - Phone:212-421-4880
Practice Address - Fax:212-644-8341
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist