Kim Abbegail Tan Aldecoa
Student in an Organized Health Care Education/Training Program in Pontiac, MI. Individual provider (NPI-1).
Details
- NPI
- 1700517778
- Entity type
- Individual (NPI-1)
- Name
- Kim Abbegail Tan Aldecoa
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 21, 2022
- Certification date
- Jun 21, 2022
- Last updated
- Jun 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
St. Joseph Mercy Oakland Hospital,44405 Woodward AvenueMedical Education Department H23
Pontiac, MI 48341
Phone 248-858-6233 · Fax 248-858-3244
Mailing address
St. Joseph Mercy Oakland Hospital,44405 Woodward AvenueMedical Education Department H23
Pontiac, MI 48341
Phone 248-858-6233 · Fax 248-858-3244
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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