Individual
DR. MADELINE P TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6601 VENTNOR AVE, SUITE #14, VENTNOR CITY, NJ 08406
(609) 487-6507
(609) 487-6508
Mailing address
6601 VENTNOR AVE, SUITE #14, VENTNOR CITY, NJ 08406
(609) 487-6507
(609) 487-6508
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06846600
NJ
208000000X
Pediatrics Physician
35647
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0161144
—
NJ
05
—
64016579
—
KY
Enumeration date
01/19/2006
Last updated
10/05/2012
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