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Individual

KEVIN TAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8014 18TH AVE, BROOKLYN, NY 11214-1706
(718) 236-2747
Mailing address
9411 59TH AVE APT A9, ELMHURST, NY 11373-5101
(856) 417-6004

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
064645
NY

Other

Enumeration date
09/24/2018
Last updated
09/24/2018
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