Provider Demographics
NPI:1720524358
Name:TSANG, ELLEN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:TSANG
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215-26 23RD ROAD
Mailing Address - Street 2:APT #1
Mailing Address - City:BAY TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11360
Mailing Address - Country:US
Mailing Address - Phone:646-322-5775
Mailing Address - Fax:
Practice Address - Street 1:215-26 23RD ROAD
Practice Address - Street 2:APT #1
Practice Address - City:BAY TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11360
Practice Address - Country:US
Practice Address - Phone:646-322-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0138331225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist