Organization
FIRST RIVERSIDE MEDICAL CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XIN TAN MD (PRESIDENT)
(718) 661-4800
Entity
Organization
Contact information
Practice address
4242 COLDEN ST, SUITE L17, FLUSHING, NY 11355-4855
(718) 661-4800
(718) 888-2701
Mailing address
4242 COLDEN ST, SUITE L17, FLUSHING, NY 11355-4855
(718) 661-4800
(718) 888-2701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
219846
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02129591
—
NY
Enumeration date
02/23/2010
Last updated
02/23/2010
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