Provider Demographics
NPI:1750484176
Name:TSAI, CHING-RONG (MD)
Entity Type:Individual
Prefix:
First Name:CHING-RONG
Middle Name:
Last Name:TSAI
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 1:19 LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-2022
Mailing Address - Country:US
Mailing Address - Phone:845-796-2600
Mailing Address - Fax:845-796-2026
Practice Address - Street 1:19 LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-2022
Practice Address - Country:US
Practice Address - Phone:845-796-2600
Practice Address - Fax:845-796-2026
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118750208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00306327Medicaid
B78539Medicare UPIN