Provider Demographics
NPI:1295876241
Name:TSAI, JUDY (OD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:TSAI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4117 HARBOUR CV
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-1576
Mailing Address - Country:US
Mailing Address - Phone:517-980-1663
Mailing Address - Fax:
Practice Address - Street 1:1982 W GRAND RIVER AVE
Practice Address - Street 2:PEARLE VISION
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1736
Practice Address - Country:US
Practice Address - Phone:517-349-2050
Practice Address - Fax:517-349-7209
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004163152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN34040087, N26930218Medicare PIN