Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | P10962 | NY |
NPI | 1336620004 |
---|---|
Provider Name | Jianhong Winson Tan |
First Address | New York, NY 10065-6342 |
Second Address | New York, NY 10065-6342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2018 |
Last Update Date | 22/08/2018 |