Provider Demographics
NPI:1376766733
Name:TSAI, ROGER EJ (DPT, OCS, GCS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:EJ
Last Name:TSAI
Suffix:
Gender:M
Credentials:DPT, OCS, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S SERVICE RD # 254
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2254
Mailing Address - Country:US
Mailing Address - Phone:631-839-6830
Mailing Address - Fax:
Practice Address - Street 1:972 BRUSH HOLLOW RD
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-1740
Practice Address - Country:US
Practice Address - Phone:516-876-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist