Healthcare Provider Details

I. General information

NPI: 1437128568
Provider Name (Legal Business Name): XIAOYIN TANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 ROUTE 33 SUITE B
NEPTUNE NJ
07753-6104
US

IV. Provider business mailing address

2240 ROUTE 33 SUITE B
NEPTUNE NJ
07753-6104
US

V. Phone/Fax

Practice location:
  • Phone: 732-897-3985
  • Fax: 732-897-3982
Mailing address:
  • Phone: 732-897-3985
  • Fax: 732-897-3982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number25MA07222100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: