Provider Demographics
NPI:1851370316
Name:NG, GREGORY K (DPM)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:K
Last Name:NG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-9521
Mailing Address - Country:US
Mailing Address - Phone:856-783-9690
Mailing Address - Fax:856-627-7939
Practice Address - Street 1:496 COOPER RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9521
Practice Address - Country:US
Practice Address - Phone:856-783-9690
Practice Address - Fax:856-627-7939
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00265300213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8683107Medicaid
NJ8683107Medicaid
NJU86641Medicare UPIN
NJ1750466173Medicare NSC
NJ1851370316Medicare NSC