Provider Demographics
NPI:1528221025
Name:NG, ELIZA (MD)
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:
Last Name:NG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 BROADWAY
Mailing Address - Street 2:7C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3539
Mailing Address - Country:US
Mailing Address - Phone:212-982-4429
Mailing Address - Fax:
Practice Address - Street 1:395 BROADWAY
Practice Address - Street 2:7C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3539
Practice Address - Country:US
Practice Address - Phone:212-982-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223863207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology