Provider Demographics
NPI:1750348983
Name:TSOU, JOHN YULE (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:YULE
Last Name:TSOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 UNION ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3003
Mailing Address - Country:US
Mailing Address - Phone:518-828-0947
Mailing Address - Fax:518-822-0520
Practice Address - Street 1:815 UNION ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3003
Practice Address - Country:US
Practice Address - Phone:518-828-0947
Practice Address - Fax:518-822-0520
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00972312Medicaid
NY80D221Medicare ID - Type Unspecified
NY00972312Medicaid