Provider Demographics
NPI:1942577986
Name:SANG, TUYCHE (ABO)
Entity Type:Individual
Prefix:
First Name:TUYCHE
Middle Name:
Last Name:SANG
Suffix:
Gender:F
Credentials:ABO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6717
Mailing Address - Country:US
Mailing Address - Phone:718-426-8600
Mailing Address - Fax:718-507-2729
Practice Address - Street 1:7902 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6717
Practice Address - Country:US
Practice Address - Phone:718-426-8600
Practice Address - Fax:718-507-2729
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064800156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician