Provider Demographics
NPI:1750588109
Name:TSAI, VIVIAN (MD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:TSAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 ARLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1141
Mailing Address - Country:US
Mailing Address - Phone:617-233-7695
Mailing Address - Fax:
Practice Address - Street 1:116 ARLEIGH RD
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1141
Practice Address - Country:US
Practice Address - Phone:617-233-7695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94943208000000X
NY251267208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics