Individual
ROGER FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
HEALTH SCIENCES CTR, T16-080, STONY BROOK, NY 11794-0001
(631) 444-1226
Mailing address
HEALTH SCIENCES CTR, T16-080, STONY BROOK, NY 11794-0001
(631) 444-1226
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MT184514
PA
Other
Enumeration date
12/14/2006
Last updated
09/15/2008
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