Provider Demographics
NPI:1659646982
Name:JOHN Y. TSOU, M.D.
Entity type:Organization
Organization Name:JOHN Y. TSOU, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TSOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-828-0947
Mailing Address - Street 1:815 UNION ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3003
Mailing Address - Country:US
Mailing Address - Phone:518-828-0947
Mailing Address - Fax:518-822-0520
Practice Address - Street 1:815 UNION ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3003
Practice Address - Country:US
Practice Address - Phone:518-828-0947
Practice Address - Fax:518-822-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129662261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00972312Medicaid
NY00972312Medicaid
NYB19417Medicare UPIN