Wolf Ridge Medical Wellness

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

WOLF RIDGE MEDICAL WELLNESS

Practice address

100 New Broadway Apt 404
Rensselaer, NY 12144-2159

Phone

(401) 575-3534

NPI assigned

Jan 27, 2020

Last updated

Jan 27, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Tsang, MD

Title

Owner

Phone

(401) 575-3534

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1184255481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NEW BROADWAY APT 404",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121442159",
            "telephone_number": "401-575-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NEW BROADWAY APT 404",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121442159",
            "telephone_number": "401-575-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF RIDGE MEDICAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "TSANG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-575-3534",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health & General Preventive Medicine Physician in Rensselaer, NY
• Providers in Rensselaer, NY by specialty
• Public Health & General Preventive Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.