Healthcare Provider Details

I. General information

NPI: 1275914772
Provider Name (Legal Business Name): ANLY K TSANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD INOVA FAIRFAX MEDICAL CAMPUS
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

3300 GALLOWS RD INOVA FAIRFAX MEDICAL CAMPUS
FALLS CHURCH VA
22042-3307
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-3582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0116028025
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: