Provider Demographics
NPI:1780874461
Name:TANG, MICHAEL DONALD (MD-PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DONALD
Last Name:TANG
Suffix:
Gender:M
Credentials:MD-PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 OCEAN AVE
Mailing Address - Street 2:APT. #2C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3270
Mailing Address - Country:US
Mailing Address - Phone:718-629-8129
Mailing Address - Fax:
Practice Address - Street 1:2900 OCEAN AVE
Practice Address - Street 2:APT. #2C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3270
Practice Address - Country:US
Practice Address - Phone:718-629-8129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118248207P00000X
NY244304-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine