Individual
DR. JADE MARIE TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1621 EASTCHESTER RD, PEDIATRICS, BRONX, NY 10461-2604
(718) 405-8048
Mailing address
226 E 74TH ST, APT 5G, NEW YORK, NY 10021-3625
(410) 925-1598
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
258458
NY
208000000X
Pediatrics Physician
Primary
D67632
MD
208000000X
Pediatrics Physician
P20266
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018305900
—
MD
Enumeration date
01/31/2007
Last updated
09/02/2010
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