Provider Demographics
NPI:1306597950
Name:HANG, TOM B
Entity type:Individual
Prefix:
First Name:TOM
Middle Name:B
Last Name:HANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 SOUTH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1268
Mailing Address - Country:US
Mailing Address - Phone:609-980-5851
Mailing Address - Fax:
Practice Address - Street 1:2116 SOUTH ST APT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1268
Practice Address - Country:US
Practice Address - Phone:609-980-5851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN740374163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN740374OtherRN LICENSE PENNSYLVANIA