Individual
DR. IRENE J. TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD445427
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010037521CT01
BCBS PROVIDER ID
CT
01
—
1891982005
GROUP NPI
CT
01
—
2V7063
HEALTH NET PROVIDER ID
CT
01
—
C03453
MEDICARE GROUP PIN
CT
Enumeration date
01/26/2006
Last updated
11/06/2020
Update your record
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