Provider Demographics
NPI:1871560987
Name:NGEO, JUANITA LO (MD)
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:LO
Last Name:NGEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 WYCKOFF AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237
Mailing Address - Country:US
Mailing Address - Phone:718-381-3939
Mailing Address - Fax:718-381-1850
Practice Address - Street 1:126 WYKOFF AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237
Practice Address - Country:US
Practice Address - Phone:718-381-3939
Practice Address - Fax:718-381-1950
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1148491207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY21722OtherHEALTH CARE PARTNERS MANA
NY4556405OtherAETNA HEALTH PLAN
BK0018201OtherAMERICHOICE
NY1199OtherBENEFIT FUND
NY1999146OtherUNITED HEALTH CARE
NY0893659OtherAETNA HEALTH PLAN
NY0087022OtherGHI
NYP74172OtherOXFORD HEALTH PLAN
NY00210480Medicaid
NY566941OtherEMPIRE BLUE CHOICE
NY0662023008OtherCIGNA
NY24927POtherHIP
NY0087022OtherGHI
NY4556405OtherAETNA HEALTH PLAN