Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 11013773A | IN |
N | 208600000X | Surgeon | 11013773A | IN |
N | 208200000X | Surgeon | 4301099765 | MI |
N | 208600000X | Surgeon | 4301099765 | MI |
N | 2086S0120X | Pediatric Surgery | 4301099765 | MI |
Y | 2086S0120X | Pediatric Surgery | MD424768 | PA |
NPI | 1285892067 |
---|---|
Provider Name | Anthony Y Tsai |
First Address | Hershey, PA 17033-0858 |
Second Address | Hartford, CT 06106-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 17/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11013773A | MEDICAL RESIDENCY PERMIT (01) | IN |