Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 025759 | NY |
NPI | 1053642058 |
---|---|
Provider Name | Hiu Kwan Annie Tang |
First Address | New York, NY 10013-4135 |
Second Address | New York, NY 10013-4135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2010 |
Last Update Date | 15/01/2010 |