MEDICARE: MICHELLE ONG FNP-BC

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	363LF0000X	Family Nurse Practitioner	F341466-1	NY

General Provider Information

NPI Number	:	1336658491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ONG FNP-BC

Provider Business Mailing Address
First Line	:	4310 CRESCENT ST APT 1603
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4254
Country	:	US
Telephone Number	:	646-667-9161
Fax Number	:

Provider Business Practice Location Address
First Line	:	4310 CRESCENT ST APT 1603
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4254
Country	:	US
Telephone Number	:	646-667-9161
Fax Number	:

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

Provider Enumeration Date	:	09/21/2017
Last Update Date	:	07/21/2022

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Directions to “ MICHELLE ONG FNP-BC” Practice Location

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