Healthcare Provider Details

I. General information

NPI: 1083602858
Provider Name (Legal Business Name): ANDERSON F TSAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 MAIN ST STE B4
KEANSBURG NJ
07734-2063
US

IV. Provider business mailing address

319 MAIN ST STE B4
KEANSBURG NJ
07734-2063
US

V. Phone/Fax

Practice location:
  • Phone: 732-787-0568
  • Fax: 732-787-0270
Mailing address:
  • Phone: 732-787-0568
  • Fax: 732-787-0270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA03083100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: