Provider Demographics
NPI:1902930886
Name:TANG BENJES & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:TANG BENJES & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-237-3233
Mailing Address - Street 1:332 WASHINGTON ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6219
Mailing Address - Country:US
Mailing Address - Phone:781-237-3233
Mailing Address - Fax:
Practice Address - Street 1:332 WASHINGTON ST
Practice Address - Street 2:SUITE 305
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-6219
Practice Address - Country:US
Practice Address - Phone:781-237-3233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54884174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA703158OtherSTEPHEN TANG TUFTS IND. #
MAJ05985OtherSTEPHEN TANG BCBSMA IND #
MA3202577Medicaid
MA0300378OtherUNITED
MA2358372OtherAETNA
MA691111OtherTUFTS GROUP #
MA9749888Medicaid
MAM17575OtherBCBSMA GROUP #
MAJ05985Medicare ID - Type UnspecifiedSTEPHEN TANG INDIVIDUAL #
MA3202577Medicaid
MA9749888Medicaid