Provider Demographics
NPI:1568837722
Name:NG, ANTHONY (RN)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 BROOME STREET
Mailing Address - Street 2:APARMENT 10
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3201
Mailing Address - Country:US
Mailing Address - Phone:347-480-8310
Mailing Address - Fax:
Practice Address - Street 1:390 BROOME STREET
Practice Address - Street 2:APARMENT 10
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3201
Practice Address - Country:US
Practice Address - Phone:347-480-8310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY708480163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse