Individual
DR. GRACE TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
834 FORT SALONGA RD STE D, NORTHPORT, NY 11768-3157
(631) 757-4440
(631) 757-4593
Mailing address
834 FORT SALONGA RD STE D, NORTHPORT, NY 11768-3157
(631) 757-4440
(631) 757-4593
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NY TUV 7209
NY
Other
Enumeration date
08/20/2007
Last updated
07/05/2016
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