Healthcare Provider Details

I. General information

NPI: 1487108098
Provider Name (Legal Business Name): ANGELA C TANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 IMPERIAL PL UNIT 2D
PROVIDENCE RI
02903-4642
US

IV. Provider business mailing address

455 TOLL GATE RD PRC AND CREDENTIALING
WARWICK RI
02886-2759
US

V. Phone/Fax

Practice location:
  • Phone: 401-727-4800
  • Fax: 401-921-6923
Mailing address:
  • Phone: 401-273-0641
  • Fax: 401-273-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD19432
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: