Basic Information
| Provider Information | |||||||||
| NPI: | 1003291428 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NG | ||||||||
| FirstName: | ERNEST | ||||||||
| MiddleName: | CHI KONG | ||||||||
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| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 615 E PRINCETON ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073035781 | ||||||||
| FaxNumber: | 4073035794 | ||||||||
| Practice Location | |||||||||
| Address1: | 615 E PRINCETON ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073035781 | ||||||||
| FaxNumber: | 4073035794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2015 | ||||||||
| LastUpdateDate: | 10/16/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA9109498 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.