Provider Demographics
NPI:1184480717
Name:TSENG, JASON
Entity type:Individual
Prefix:
First Name:JASON
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 1:201 CIVIC CENTER DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8033
Mailing Address - Country:US
Mailing Address - Phone:207-623-8223
Mailing Address - Fax:
Practice Address - Street 1:201 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8033
Practice Address - Country:US
Practice Address - Phone:207-623-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-01671183500000X
MEPR72466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist