1952365769 NPI number — DR. PATRICIA TSANG M.D.

Table of content: DR. PATRICIA TSANG M.D. (NPI 1952365769)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952365769 NPI number — DR. PATRICIA TSANG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TSANG
Provider First Name:
PATRICIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952365769
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 N ACADEMY AVE
Provider Second Line Business Mailing Address:
NEWARK BETH ISRAEL MED. CTR., LABORATORY & PATHOLOGY
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17822-4903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-271-6144
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 E MOUNTAIN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILKES BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18711-0027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-808-7830
Provider Business Practice Location Address Fax Number:
570-808-6039
Provider Enumeration Date:
04/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZH0000X , with the licence number:  25MF00081000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0101X , with the licence number: MD453727 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0102X , with the licence number: 25MF00081000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: N91000923500 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: NP107837 . This is a "AMERIGROUP/AMERICAID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5099451 . This is a "GROUP HEALTH INCORPORATED" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 52R021 . This is a "WELLCHOICE/EMPIRE HEALTHC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8897409 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: NP35363 . This is a "UNIVERSITY HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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