Healthcare Provider Details

I. General information

NPI: 1356338768
Provider Name (Legal Business Name): ANDERSON F TSAI MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 11/28/2007
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: DR. ANDERSON F TSAI
Title or Position: OWNER
Credential: MD
Phone: 732-787-0568