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General NPI Number Information
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NPI Number | 1518894534
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Entity Type | Individual
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Provider Name | JAKE ANG
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Gender | Male
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 4 RUTLAND AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-5320
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Country | US
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Telephone | 929-428-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 49 S 16TH ST
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4914
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Country | US
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Telephone | 929-428-1760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | N04955
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License Number State | NY
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