Provider Demographics
NPI:1184790339
Name:NG, PETER YAT (L AC, CA)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:YAT
Last Name:NG
Suffix:
Gender:M
Credentials:L AC, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MOUNTAIN BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5605
Mailing Address - Country:US
Mailing Address - Phone:908-756-1538
Mailing Address - Fax:
Practice Address - Street 1:27 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5605
Practice Address - Country:US
Practice Address - Phone:908-756-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00051600171100000X
NY3373171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MZ00051600OtherACUPUNCTURE