Provider Demographics
NPI:1184298523
Name:TSANG, HENRY
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:TSANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SOUTH GRANT AVENUE
Mailing Address - Street 2:MEDICAL EDUCATION DEPARTMENT
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215
Mailing Address - Country:US
Mailing Address - Phone:614-566-9699
Mailing Address - Fax:614-566-8073
Practice Address - Street 1:111 S. GRANT AVENUE
Practice Address - Street 2:MEDICAL EDUCATION DEPARTMENT
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215
Practice Address - Country:US
Practice Address - Phone:614-566-9699
Practice Address - Fax:614-566-8073
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017261390200000X
SCLL83595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine