Provider Demographics
NPI:1205122918
Name:TSAI, JUDY P (DO)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:P
Last Name:TSAI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 WILLOW AVE
Mailing Address - Street 2:APT 3B
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4032
Mailing Address - Country:US
Mailing Address - Phone:917-882-0461
Mailing Address - Fax:
Practice Address - Street 1:18 JACKSON AVE STE 3
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3137
Practice Address - Country:US
Practice Address - Phone:516-991-9607
Practice Address - Fax:516-802-2534
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269908208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice