Provider Demographics
NPI:1306886015
Name:NG, SZE-FONG (MD)
Entity type:Individual
Prefix:
First Name:SZE-FONG
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HEALTHY WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1551
Mailing Address - Country:US
Mailing Address - Phone:516-632-3666
Mailing Address - Fax:
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1078
Practice Address - Country:US
Practice Address - Phone:516-561-6119
Practice Address - Fax:516-594-2623
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02009245Medicaid
NY02009245Medicaid
50C451Medicare ID - Type Unspecified