Individual
KEJIAN TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
181 MAPLE ST, MASSENA, NY 13662-1012
(315) 842-3095
(315) 842-3035
Mailing address
1 HOSPITAL DRIVE, MASSENA, NY 13662
(315) 769-4200
(315) 769-4353
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
E4568
AR
2084N0400X
Neurology Physician
Primary
224356-1
NY
2084N0400X
Neurology Physician
E-4568
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02281450
—
NY
Enumeration date
05/04/2006
Last updated
01/26/2015
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