Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | NA | NY |
NPI | 1013367994 |
---|---|
Provider Name | Rong Tang |
First Address | Rochester, NY 14621-3095 |
Second Address | Rochester, NY 14621-3001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2016 |
Last Update Date | 08/02/2019 |