Healthcare Provider Details

I. General information

NPI: 1306019948
Provider Name (Legal Business Name): HO YEE TIONG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE A110
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

26700 ALSACE CT APT 204
BEACHWOOD OH
44122-7574
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-5978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number57.012769
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number57.012769
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: