Organization
STAMFORD ARTHRITIS CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE J TAN M.D. (PRESIDENT)
(203) 487-0280
Entity
Organization
Contact information
Practice address
1266 E MAIN ST, SUITE 700R, STAMFORD, CT 06902-3546
(203) 487-0280
(203) 487-0279
Mailing address
1266 E MAIN ST, SUITE 700R, STAMFORD, CT 06902-3546
(203) 487-0280
(203) 487-0279
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
037521
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010037521CT01
BCBS PROVIDER ID
CT
01
—
1891982005
ORGANIZATION NPI
CT
01
—
2V7063
HEALTH NET PROVIDER ID
CT
01
—
C03453
MEDICARE GROUP PIN
CT
Enumeration date
10/02/2007
Last updated
02/22/2012
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