MEDICARE: DR. LISA ENG D.O.

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	207V00000X	Obstetrics & Gynecology Physician	188325	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952373912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA ENG D.O.

Provider Business Mailing Address
First Line	:	128 MOTT ST STE 401
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-5575
Country	:	US
Telephone Number	:	212-219-2723
Fax Number	:	718-795-4395

Provider Business Practice Location Address
First Line	:	128 MOTT ST
Second Line	:	SUITE 401
City	:	NEW YORK
State	:	NY
Zip	:	10013-5540
Country	:	US
Telephone Number	:	212-219-2723
Fax Number	:	718-795-4395

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	06/13/2016

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