Individual
JIA YI TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5000
Mailing address
9 S 3RD ST APT 2, HARRISON, NJ 07029-2081
(862) 373-7618
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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