Provider Demographics
NPI:1679538391
Name:NG, JOAQUIN (MD)
Entity type:Individual
Prefix:DR
First Name:JOAQUIN
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE BRISAIDA #24,URB.MUNOZ RIVERA
Mailing Address - Street 2:CALLE BRISAIDA#24,URB. MUNOZ RIVERA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-731-2978
Mailing Address - Fax:787-731-2978
Practice Address - Street 1:BRISAIDA STREET#24,URB. MR
Practice Address - Street 2:BRISAIDA STREET#24,URB MR
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-731-2978
Practice Address - Fax:787-731-2978
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14380146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1-19-103Medicare UPIN