Individual
GARY XIA VERN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(917) 576-9204
Mailing address
1365 YORK AVE APT 11H, NEW YORK, NY 10021-4046
(917) 576-9204
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
303298
NY
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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