Provider Demographics
NPI:1497844104
Name:TSENG, AMY (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:TSENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2453 SUN REEF RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-6882
Mailing Address - Country:US
Mailing Address - Phone:702-234-0059
Mailing Address - Fax:
Practice Address - Street 1:2870 S JONES BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5643
Practice Address - Country:US
Practice Address - Phone:702-870-7111
Practice Address - Fax:702-870-3496
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019827Medicaid
NVVMD7877Medicare ID - Type Unspecified
NV002019827Medicaid