Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MA55250 | NJ |
NPI | 1083637896 |
---|---|
Provider Name | Dr. Lin-Lan Tang |
First Address | Warren, NJ 07059-5605 |
Second Address | Warren, NJ 07059-5605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 14/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E71929 | (02) | NJ |