Tommy Tan, PA-C
Physician Assistant in Jamaica, NY. Individual provider (NPI-1).
NPI number1982071916
StatusActive
Last updated in NPPESAug 25, 2015
Details
- NPI
- 1982071916
- Entity type
- Individual (NPI-1)
- Name
- Tommy Tan
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2015
- Last updated
- Aug 25, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 018913 | NY | Yes |
Practice location
8268 164th StJamaica, NY 11432-1121
Phone 718-883-3000
Mailing address
8268 164th StSuite 1b-02
Jamaica, NY 11432-1121
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