Individual
REYNALDO GO TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8122 7TH AVE, BROOKLYN, NY 11228-2805
(718) 836-0225
(718) 836-0114
Mailing address
8122 7TH AVE, BROOKLYN, NY 11228-2805
(718) 836-0225
(718) 836-0114
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
202867
NY
207RN0300X
Nephrology Physician
Primary
202867
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01609067
—
NY
Enumeration date
07/06/2006
Last updated
09/29/2021
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