Individual
DR. CHANGTAI TIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-3806
(631) 689-8333
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-8434
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.077594
IL
207RH0003X
Hematology & Oncology Physician
Primary
125-077594
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2021
Last updated
06/19/2024
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