Basic Information
| Provider Information | |||||||||
| NPI: | 1871580647 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TSO | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 UNION SQUARE EAST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128448100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 741 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071044309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9734831300 | ||||||||
| FaxNumber: | 9736761396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2005 | ||||||||
| LastUpdateDate: | 02/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 25MA08841200 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 196000 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 196000 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 25MA08841200 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.