Provider Demographics
NPI:1508051137
Name:PAK S. TANG, M.D., INC.
Entity Type:Organization
Organization Name:PAK S. TANG, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAK
Authorized Official - Middle Name:S
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-505-0901
Mailing Address - Street 1:PO BOX 1317
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-9317
Mailing Address - Country:US
Mailing Address - Phone:914-505-0901
Mailing Address - Fax:914-574-5326
Practice Address - Street 1:508 CENTRAL PARK AVE
Practice Address - Street 2:#5302
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1059
Practice Address - Country:US
Practice Address - Phone:914-505-0901
Practice Address - Fax:914-574-5326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI11113207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH102780Medicare PIN
HIB88361Medicare UPIN