Individual
CONCHITA TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3648 SENECA STREET, WEST SENECA, NY 14224-3400
(716) 675-1410
(716) 675-4041
Mailing address
3648 SENECA STREET, WEST SENECA, NY 14224-3400
(716) 675-1410
(716) 675-4041
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
1179141
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00649550
—
NY
Enumeration date
03/14/2006
Last updated
07/08/2007
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