Provider Demographics
NPI:1881303980
Name:TSAI, JUSTIN G (EMT, BSN)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:G
Last Name:TSAI
Suffix:
Gender:M
Credentials:EMT, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 IVANHOE DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4135
Mailing Address - Country:US
Mailing Address - Phone:917-420-5878
Mailing Address - Fax:
Practice Address - Street 1:144 IVANHOE DR
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4135
Practice Address - Country:US
Practice Address - Phone:917-420-5878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY488043207PE0004X
NJ615178207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services