MEDICARE: DR. CHI TANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	57294	CT
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	57294	CT

General Provider Information

NPI Number	:	1013263870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHI TANG MD

Provider Business Mailing Address
First Line	:	67 MAPLE AVE
Second Line	:
City	:	DERBY
State	:	CT
Zip	:	06418-1328
Country	:	US
Telephone Number	:	203-732-1330
Fax Number	:	203-732-1332

Provider Business Practice Location Address
First Line	:	135 DIVISION ST STE 1
Second Line	:
City	:	ANSONIA
State	:	CT
Zip	:	06401-2135
Country	:	US
Telephone Number	:	203-735-3500
Fax Number	:	203-735-0505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	09/19/2023

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Directions to “ DR. CHI TANG MD” Practice Location

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