MEDICARE: DR. WAN-HAI TSENG PH.D., LCSW

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	1041C0700X	Clinical Social Worker	090015	NY

General Provider Information

NPI Number	:	1780100107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAN-HAI TSENG PH.D., LCSW

Provider Business Mailing Address
First Line	:	329 WILLOW AVE APT 2R
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-3860
Country	:	US
Telephone Number	:	718-288-2024
Fax Number	:

Provider Business Practice Location Address
First Line	:	1270 AVENUE OF THE AMERICAS FL 7
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10020-1702
Country	:	US
Telephone Number	:	718-288-2024
Fax Number	:

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

Provider Enumeration Date	:	08/17/2017
Last Update Date	:	01/06/2021

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