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NPI Code Detail

MEDICARE: JULIE S TANG MD

MEDICARE: JULIE S TANG MD
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
1207Q00000XFamily Medicine Physician319004NY

General Provider Information

NPI Number : 1780147256
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE S TANG MD
Provider Business Mailing Address
First Line : 425 JACK MARTIN BLVD
Second Line :
City : BRICK
State : NJ
Zip : 08724-7732
Country : US
Telephone Number : 732-840-2200
Fax Number :
Provider Business Practice Location Address
First Line : 1033 NORTHERN BLVD
Second Line :
City : ROSLYN
State : NY
Zip : 11576-1502
Country : US
Telephone Number : 516-473-0782
Fax Number : 516-253-2150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2019
Last Update Date : 09/23/2022

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