Provider Demographics
NPI:1699927566
Name:JANG, THOMAS LEE (MD, MPH, FACS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:JANG
Suffix:
Gender:M
Credentials:MD, MPH, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 LITTLE ALBANY STREET
Mailing Address - Street 2:RUTGERS CANCER INSTITUTE OF NEW JERSEY
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08903
Mailing Address - Country:US
Mailing Address - Phone:732-235-2043
Mailing Address - Fax:732-235-6596
Practice Address - Street 1:195 LITTLE ALBANY STREET
Practice Address - Street 2:RUTGERS CANCER INSTITUTE OF NEW JERSEY
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08903
Practice Address - Country:US
Practice Address - Phone:732-235-2043
Practice Address - Fax:732-235-6596
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60 238670208800000X
NJ25MA08557300208800000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0201685Medicaid
NJ0201685Medicaid