Provider Demographics
NPI:1710090410
Name:ENG, MICHAEL DICK-MING (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DICK-MING
Last Name:ENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 23RD ST
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4508
Mailing Address - Country:US
Mailing Address - Phone:212-529-3788
Mailing Address - Fax:646-513-3274
Practice Address - Street 1:115 EAST 23RD STREET
Practice Address - Street 2:10TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-529-3788
Practice Address - Fax:646-513-3274
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236014207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0271Medicaid
NY4V6021Medicare ID - Type Unspecified
NYI33537Medicare UPIN