Individual
TYLER TAN FUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
19 BEACH LN, NORTH HAVEN, CT 06473-4002
(203) 239-6878
Mailing address
19 BEACH LN, NORTH HAVEN, CT 06473-4002
(203) 239-6878
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022515
NY
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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