MEDICARE: JOHN NGO

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	060988	NY

General Provider Information

NPI Number	:	1366818247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN NGO

Provider Business Mailing Address
First Line	:	8646 17TH AVE # 1F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3602
Country	:	US
Telephone Number	:	347-587-1826
Fax Number	:

Provider Business Practice Location Address
First Line	:	6628 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4314
Country	:	US
Telephone Number	:	718-236-6790
Fax Number	:

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

Provider Enumeration Date	:	08/14/2015
Last Update Date	:	08/17/2015

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Directions to “ JOHN NGO ” Practice Location

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