Individual
DENNIS TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
300 MOUNT AUBURN ST STE 517, CAMBRIDGE, MA 02138-5665
(617) 492-3500
Mailing address
300 MT AUBURN ST, SUITE 517, CAMBRIDGE, MA 02138-5665
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN2313462
MA
363L00000X
Nurse Practitioner
Primary
RN2313462
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255903696
—
MA
Enumeration date
07/14/2021
Last updated
02/23/2023
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