Provider Demographics
NPI:1750379665
Name:TSANG, PETER H (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:H
Last Name:TSANG
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 1:1403 SPRING LN
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3130
Mailing Address - Country:US
Mailing Address - Phone:507-476-1039
Mailing Address - Fax:
Practice Address - Street 1:268 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3599
Practice Address - Country:US
Practice Address - Phone:212-379-6999
Practice Address - Fax:212-379-6936
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184591207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G16086Medicare UPIN