MEDICARE: ELAINE NG RN

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	163W00000X	Registered Nurse	813241	NY

General Provider Information

NPI Number	:	1932871993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE NG RN

Provider Business Mailing Address
First Line	:	261 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4909
Country	:	US
Telephone Number	:	646-423-1612
Fax Number	:

Provider Business Practice Location Address
First Line	:	261 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4909
Country	:	US
Telephone Number	:	646-423-1612
Fax Number	:

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

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	09/29/2021

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