Provider Demographics
NPI:1174555262
Name:ENG, ANGIE MC (MD)
Entity type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:MC
Last Name:ENG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:635 MADISON AVE
Mailing Address - Street 2:17TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1009
Mailing Address - Country:US
Mailing Address - Phone:212-717-4964
Mailing Address - Fax:212-717-4970
Practice Address - Street 1:635 MADISON AVE
Practice Address - Street 2:17TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1009
Practice Address - Country:US
Practice Address - Phone:212-717-4964
Practice Address - Fax:212-717-4970
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-10-11
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Provider Licenses
StateLicense IDTaxonomies
NY170925207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE87386Medicare UPIN