Provider Demographics
NPI:1710132147
Name:NG, JENNY KEI-MAN (MA)
Entity Type:Individual
Prefix:MISS
First Name:JENNY
Middle Name:KEI-MAN
Last Name:NG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1798 3RD AVE
Mailing Address - Street 2:APT 2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6195
Mailing Address - Country:US
Mailing Address - Phone:212-360-1218
Mailing Address - Fax:212-360-1218
Practice Address - Street 1:1798 3RD AVE
Practice Address - Street 2:APT 2A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6195
Practice Address - Country:US
Practice Address - Phone:212-360-1218
Practice Address - Fax:212-360-1218
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1822194222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist