Provider Demographics
NPI:1396306643
Name:NG, LI QING (OD)
Entity type:Individual
Prefix:
First Name:LI QING
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 1:200 BANNING ST STE 130
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3486
Mailing Address - Country:US
Mailing Address - Phone:302-678-1700
Mailing Address - Fax:302-678-2330
Practice Address - Street 1:200 BANNING ST STE 130
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3486
Practice Address - Country:US
Practice Address - Phone:302-678-1700
Practice Address - Fax:302-678-2330
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2677152W00000X
DEI3-0011469152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist