MEDICARE: DR. JUDY P TSAI D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	269908	NY

General Provider Information

NPI Number	:	1205122918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDY P TSAI D.O.

Provider Business Mailing Address
First Line	:	712 WILLOW AVE
Second Line	:	APT 3B
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4032
Country	:	US
Telephone Number	:	917-882-0461
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 JACKSON AVE STE 3
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-3137
Country	:	US
Telephone Number	:	516-991-9607
Fax Number	:	516-802-2534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	02/13/2019

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