Provider Demographics
NPI:1902992969
Name:ENG, JUDY SEA-YUEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:SEA-YUEN
Last Name:ENG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JUDY
Other - Middle Name:SEA-YUEN
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:170 WEST 12TH STREET
Mailing Address - Street 2:ST VINCENTS HOSPITAL DEPT OF COMMUNITY MEDICINE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:212-604-8073
Mailing Address - Fax:212-604-7627
Practice Address - Street 1:170 WEST 12TH STREET
Practice Address - Street 2:ST VINCENTS HOSPITAL DEPT OF COMMUNITY MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-8073
Practice Address - Fax:212-604-7627
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3404691363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0E5011Medicare ID - Type Unspecified
P47031Medicare UPIN