Provider Demographics
NPI:1043856859
Name:TANG, BRYAN WAI YONG (PA-C)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:WAI YONG
Last Name:TANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 MORTON CT
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-4325
Mailing Address - Country:US
Mailing Address - Phone:267-640-9520
Mailing Address - Fax:
Practice Address - Street 1:824 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4478
Practice Address - Country:US
Practice Address - Phone:610-935-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-27
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA005076363A00000X
PAMA061242363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant