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Individual

VIVIAN TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
165 VANDERBILT AVE, STATEN ISLAND, NY 10304-2521
(718) 616-0993
Mailing address
1755 W 11TH ST, BROOKLYN, NY 11223-1141
(917) 588-6517

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01062601
NY

Other

Enumeration date
10/14/2022
Last updated
10/14/2022
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