Individual
GIAC CHAN NGUYEN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 GRANDVIEW AVE, STE 105, WATERBURY, CT 06708-2519
(203) 694-8200
Mailing address
171 GRANDVIEW AVE, STE 105, WATERBURY, CT 06708-2519
(203) 755-2214
(203) 596-1133
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
028148
CT
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
028148
CT
207R00000X
Internal Medicine Physician
Primary
028148
CT
Other
Enumeration date
10/23/2006
Last updated
02/16/2022
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