Organization
ALFONSO TAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSO TAN M.D. (PRESIDENT)
(631) 589-2323
Entity
Organization
Contact information
Practice address
297 W MAIN ST, SAYVILLE, NY 11782-2523
(631) 589-2323
(631) 589-9069
Mailing address
297 W MAIN ST, SAYVILLE, NY 11782-2523
(631) 589-2323
(631) 589-9069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
115465
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00213052
—
NY
Enumeration date
11/02/2006
Last updated
11/02/2007
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