Provider Demographics
NPI:1043060940
Name:TSENG, MARCELLUS
Entity Type:Individual
Prefix:
First Name:MARCELLUS
Middle Name:
Last Name:TSENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S WELLS ST APT 530
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4531
Mailing Address - Country:US
Mailing Address - Phone:408-316-3680
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR # MCH088
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-1485
Practice Address - Fax:717-531-2077
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program