Healthcare Provider Details

I. General information

NPI: 1194650036
Provider Name (Legal Business Name): ESTHER TSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DR
FAIRFAX VA
22031-4867
US

IV. Provider business mailing address

4060 GATEWAY DR APT 5228
FAIRFAX VA
22030-5076
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-0483
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number0202219726
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: