Basic Information
Provider Information
NPI: 1295981009
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NGO
FirstName: DEBBY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 330 BROOKLINE AVE
Address2:  
City: BOSTON
State: MA
PostalCode: 022155400
CountryCode: US
TelephoneNumber: 6176675864
FaxNumber: 6176674849
Practice Location
Address1: 330 BROOKLINE AVE
Address2:  
City: BOSTON
State: MA
PostalCode: 022155400
CountryCode: US
TelephoneNumber: 6176675864
FaxNumber: 6176674849
Other Information
ProviderEnumerationDate: 08/12/2008
LastUpdateDate: 10/04/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X244877MAN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200X244877MAY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


Home