Provider Demographics
NPI:1578892170
Name:ALICE TZENG MD LLC
Entity Type:Organization
Organization Name:ALICE TZENG MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:WON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-412-0900
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-0580
Mailing Address - Country:US
Mailing Address - Phone:908-412-0900
Mailing Address - Fax:732-662-3306
Practice Address - Street 1:24 WERNIK PLACE
Practice Address - Street 2:SUITE F
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2468
Practice Address - Country:US
Practice Address - Phone:908-412-0900
Practice Address - Fax:732-662-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07608400208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ33448Medicaid
NJ33448Medicaid