Provider Demographics
NPI:1033907944
Name:PELMO, TSHERING
Entity type:Individual
Prefix:
First Name:TSHERING
Middle Name:
Last Name:PELMO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4007 73RD ST APT 4D
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3092
Mailing Address - Country:US
Mailing Address - Phone:347-662-7142
Mailing Address - Fax:
Practice Address - Street 1:4007 73RD ST APT 4D
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3092
Practice Address - Country:US
Practice Address - Phone:347-662-7142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program