Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | D0084000 | MD |
Y | 213ES0000X | Sports Medicine | D0084000 | MD |
NPI | 1356603435 |
---|---|
Provider Name | Tiffany Tsay |
First Address | Wilkes Barre, PA 18711-0027 |
Second Address | Towson, MD 21204-2065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2012 |
Last Update Date | 23/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D0084000 | MARYLAND LICENSE (01) | MD |