Individual
MRS. EMILY S. TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
90 BERGEN ST STE 7100, NEWARK, NJ 07103-2425
(973) 972-0212
(973) 972-1204
Mailing address
79 SALEM ST, EDISON, NJ 08820-2414
(732) 603-7286
(973) 972-1204
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00040000
NJ
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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