Provider Demographics
NPI:1568456606
Name:HSIAO, TSO-JEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TSO-JEN
Middle Name:
Last Name:HSIAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MANETTO HILL RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1311
Mailing Address - Country:US
Mailing Address - Phone:516-938-4550
Mailing Address - Fax:516-938-4559
Practice Address - Street 1:100 MANETTO HILL RD
Practice Address - Street 2:SUITE 209
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1311
Practice Address - Country:US
Practice Address - Phone:516-938-4550
Practice Address - Fax:516-938-4559
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197490208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6T2961Medicare ID - Type Unspecified
NYG79118Medicare UPIN