Provider Demographics
NPI:1245298157
Name:TONG, YA TZE (MD)
Entity type:Individual
Prefix:DR
First Name:YA TZE
Middle Name:
Last Name:TONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YA TZE
Other - Middle Name:
Other - Last Name:TONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:86 BAKER AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2132
Mailing Address - Country:US
Mailing Address - Phone:978-287-9310
Mailing Address - Fax:978-287-9357
Practice Address - Street 1:86 BAKER AVENUE EXT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2132
Practice Address - Country:US
Practice Address - Phone:978-287-9310
Practice Address - Fax:978-287-9357
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77476207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3123766Medicaid
MAF76961Medicare UPIN
MA3123766Medicaid