Provider Demographics
NPI:1659657625
Name:TANG, ELAINE TUYETHOA (RD)
Entity Type:Individual
Prefix:MISS
First Name:ELAINE
Middle Name:TUYETHOA
Last Name:TANG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 5TH AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5010
Mailing Address - Country:US
Mailing Address - Phone:212-433-0738
Mailing Address - Fax:
Practice Address - Street 1:347 5TH AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5010
Practice Address - Country:US
Practice Address - Phone:212-433-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-22
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01047966133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered