Individual
SUSAN TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
6050 AMMAN PL, DULLES, VA 20189-0001
(000) 000-0000
Mailing address
6050 AMMAN PL, DULLES, VA 20189-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0099721
NY
Other
Enumeration date
03/02/2009
Last updated
08/12/2024
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