Organization
JOHN J K TAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J K TAN M.D. (PRESIDENT)
(973) 746-4855
Entity
Organization
Contact information
Practice address
77 PARK ST, MONTCLAIR, NJ 07042-2962
(973) 746-4855
(973) 746-5305
Mailing address
PO BOX 3405, MEMORIAL STATION, UPPER MONTCLAIR, NJ 07043-3405
(973) 746-4855
(973) 746-5305
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
25MAO2451600
NJ
Other
Enumeration date
07/28/2009
Last updated
03/23/2011
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