Provider Demographics
NPI:1790890473
Name:THE, TIONG HIAP (MBBS)
Entity Type:Individual
Prefix:
First Name:TIONG
Middle Name:HIAP
Last Name:THE
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ORCHARD ST
Mailing Address - Street 2:PO BOX 987
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-5004
Mailing Address - Country:US
Mailing Address - Phone:845-343-7614
Mailing Address - Fax:845-343-5390
Practice Address - Street 1:10 BENTON AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5149
Practice Address - Country:US
Practice Address - Phone:845-343-7614
Practice Address - Fax:845-343-5390
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245714207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00355931Medicaid
NY01923528Medicaid
NYG92276Medicare UPIN
NY49C151Medicare ID - Type Unspecified
NY01923528Medicaid