Individual
DR. PATRICIA TING TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1158 ATLANTIC AVE, BALDWIN, NY 11510
(516) 252-9262
(516) 868-0685
Mailing address
1158 ATLANTIC AVE, BALDWIN, NY 11510-4205
(516) 252-9262
(516) 868-0685
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
190003
NY
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
190003
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01579060
—
NY
Enumeration date
10/13/2005
Last updated
07/21/2022
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