=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740311026
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | M.E. MEDICAL, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2007
-----------------------------------------------------
Last Update Date | 11/19/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 E 23RD ST 10TH FLOOR
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-4508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-529-3788
-----------------------------------------------------
Fax | 212-235-2085
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 115 E 23RD ST 10 TH FLOOR
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-4508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-529-3788
-----------------------------------------------------
Fax | 212-235-2085
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. MICHAEL ENG
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 212-253-8833
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 236014
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------