Provider Demographics
NPI:1811296718
Name:YANG, TONG (BACHELOR OF MEDICINE)
Entity type:Individual
Prefix:
First Name:TONG
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:BACHELOR OF MEDICINE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 LEMON ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1021
Mailing Address - Country:US
Mailing Address - Phone:504-319-3958
Mailing Address - Fax:
Practice Address - Street 1:2306 LEMON ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1021
Practice Address - Country:US
Practice Address - Phone:504-319-3958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS25151207ZP0102X
LAMD.207096207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology