Provider Demographics
NPI:1760671317
Name:NG, STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:NG
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 1:191 CANAL ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:191 CANAL ST
Practice Address - Street 2:SUITE 601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4524
Practice Address - Country:US
Practice Address - Phone:212-925-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000397400101OtherHEALTHPLUS
NY061214000158OtherFIDELISCARE
NY061214000158OtherCENTERCARE
NY326901OtherWELLCARE
NY00933275Medicaid
NY2589330OtherGHI
NYP765359OtherOXFORD
NY364AT1OtherEMPIRE BLUE CROSS
NY0411972OtherUNITED HEALTHCARE
NY163295OtherHEALTHFIRST
NY16329501OtherNEIGHBORHOOD HEALTH PROV
NY16329560NYOther1199
NY56255408100OtherTOUCHSTONE
NY326901OtherWELLCARE
NY163295OtherHEALTHFIRST