Healthcare Provider Details

I. General information

NPI: 1447279955
Provider Name (Legal Business Name): LIHUI TANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD
MONROEVILLE PA
15146-3513
US

IV. Provider business mailing address

232 W 25TH ST # 3R
ERIE PA
16544-0002
US

V. Phone/Fax

Practice location:
  • Phone: 412-858-2000
  • Fax:
Mailing address:
  • Phone: 814-452-5530
  • Fax: 814-452-5419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD421282
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0019442970006
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: