Individual
DR. JONATHAN PENG-SUI TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 456-2727
(215) 754-0213
Mailing address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 456-2727
(215) 754-0213
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS016598
PA
Other
Enumeration date
01/18/2008
Last updated
06/30/2009
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