Doctor Name: | MARY M TSE |
NPI Number: | 1003812421 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 22781 |
Business Practice Address: | 136 Sherman Ave Ste 301 New Haven, CT - 065115210 |
Business Phone Number: | 2037767458 |
Business Fax Number: | 2037762401 |
Mailing Address: | 136 Sherman Ave, Ste 301 NEW HAVEN |
State: | CT |
Postal Code: | 065115210 |
Phone Number: | 2037767458 |
Fax Number: | 2037762401 |
NPI Enumeration Date: | 06/21/2005 |
NPI Last Update Date: | 11/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/21/2006 |
NPI Reactivation Date: | 03/28/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 22781 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |