Individual
DR. BENG JIT TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
30 HARRISON ST, SUITE 460, JOHNSON CITY, NY 13790-2161
(607) 763-8101
(607) 763-8049
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2541
(607) 729-8156
(607) 729-2209
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
231029
NY
208D00000X
General Practice Physician
231029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000741
GHI
NY
01
—
1913021
IHA
NY
05
—
2678971
—
NY
01
—
27164801
UNIVERA
NY
01
—
40403006189
FIDELIS
NY
01
—
7238658
AETNA
NY
01
—
928140001
HEALTH NOW
NY
01
—
MDJ211
PREFERRED CARE
NY
01
—
P010231029
MONROE
NY
Enumeration date
10/07/2005
Last updated
04/21/2017
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