Individual
THOMAS TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
435 LEWIS AVE, MERIDEN, CT 06451-2101
(203) 694-8200
Mailing address
30 WOOLACOTT RD, ROCHESTER, NY 14617-5117
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/13/2024
Last updated
02/05/2025
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