MEDICARE: VICKY NG PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	35SI00723200	NJ
2	103T00000X	Psychologist	018826	NY

General Provider Information

NPI Number	:	1912153818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKY NG PHD

Provider Business Mailing Address
First Line	:	173 E 111TH ST APT 6
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-2863
Country	:	US
Telephone Number	:	678-777-5334
Fax Number	:

Provider Business Practice Location Address
First Line	:	173 E 111TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-2823
Country	:	US
Telephone Number	:	678-777-5334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2008
Last Update Date	:	03/16/2026

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Directions to “ VICKY NG PHD” Practice Location

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