Provider Demographics
NPI:1861464323
Name:TSANG, ALEXANDER CHI-SHUN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:CHI-SHUN
Last Name:TSANG
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 1:84 TIMBERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1466
Mailing Address - Country:US
Mailing Address - Phone:907-561-0774
Mailing Address - Fax:
Practice Address - Street 1:84 TIMBERWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1466
Practice Address - Country:US
Practice Address - Phone:907-561-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278622-1207W00000X
IN01054818A207W00000X
MDD85441208D00000X, 208D00000X
CT61715207W00000X
AK5655207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1015783Medicaid