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Individual

MARCO MARZAN TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
622 W 168TH ST, PH 1-137, NEW YORK, NY 10032-3720
(212) 305-2995
(212) 305-6792
Mailing address
622 W 168TH ST, PH 1-137, NEW YORK, NY 10032-3720
(212) 305-2995

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
253740
NY
207P00000X
Emergency Medicine Physician
4301088661
MI

Other

Enumeration date
05/23/2007
Last updated
05/24/2012
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