Provider Demographics
NPI:1790838183
Name:NG, ANGELA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:NG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1051
Mailing Address - Country:US
Mailing Address - Phone:917-596-9402
Mailing Address - Fax:212-219-8283
Practice Address - Street 1:87 ELIZABETH STREET
Practice Address - Street 2:PACIFIC OPTOMETRY, P.C.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-219-8260
Practice Address - Fax:212-219-8283
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006144152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist