Individual
DR. MARY ALDRENE TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15 CRAWFORD ST STE 100, NEEDHAM, MA 02494-2618
(617) 969-4100
(617) 969-3393
Mailing address
PO BOX 840294, DALLAS, TX 75284-0294
(888) 344-1160
(972) 331-3148
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
238301-1
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
238301-1
NY
Other
Enumeration date
10/29/2007
Last updated
03/21/2018
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