MEDICARE: MS. JOANNE NG S

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	183500000X	Pharmacist	044575	NY

General Provider Information

NPI Number	:	1205010055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNE NG S

Provider Business Mailing Address
First Line	:	100 DELANCEY ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-3202
Country	:	US
Telephone Number	:	212-253-0270
Fax Number	:	212-253-1795

Provider Business Practice Location Address
First Line	:	100 DELANCEY ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-3202
Country	:	US
Telephone Number	:	212-253-0270
Fax Number	:	212-253-1795

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

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	12/27/2007

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