Provider Demographics
NPI:1629031513
Name:TSANG, SAM (PT)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:TSANG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15488
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-5488
Mailing Address - Country:US
Mailing Address - Phone:516-317-4616
Mailing Address - Fax:954-423-3283
Practice Address - Street 1:10575 NW 11TH CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-6563
Practice Address - Country:US
Practice Address - Phone:516-317-4616
Practice Address - Fax:954-423-3283
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist