Provider Demographics
NPI:1366624751
Name:AMY TSENG, MD LTD
Entity Type:Organization
Organization Name:AMY TSENG, MD LTD
Other - Org Name:AMY TSENG, MD LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TSENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-870-7111
Mailing Address - Street 1:2870 S JONES BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5644
Mailing Address - Country:US
Mailing Address - Phone:702-870-7111
Mailing Address - Fax:702-870-3496
Practice Address - Street 1:2870 S JONES BLVD STE 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5644
Practice Address - Country:US
Practice Address - Phone:702-870-7111
Practice Address - Fax:702-870-3496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7877261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVMD7877Medicare PIN