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Organization
MARK TAN, M.D., P.C.
Active
Organization
MARK TAN, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK TAN M.D. (OWNER)
(631) 724-8900
Entity
Organization
Contact information
Practice address
222 MIDDLE COUNTRY RD, SUITE # 312, SMITHTOWN, NY 11787
(631) 821-5893
(631) 724-8901
Mailing address
222 MIDDLE COUNTRY RD, SUITE # 312, SMITHTOWN, NY 11787-2871
(631) 821-5893
(631) 724-8901
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
165674
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00986705
—
NY
Enumeration date
12/20/2007
Last updated
01/07/2008
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