Healthcare Provider Details

I. General information

NPI: 1346110384
Provider Name (Legal Business Name): DARWIN YUE SHENG TAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2272 MURRAY HILL RD
CLEVELAND OH
44106-2692
US

IV. Provider business mailing address

2272 MURRAY HILL RD
CLEVELAND OH
44106-2692
US

V. Phone/Fax

Practice location:
  • Phone: 929-283-8307
  • Fax:
Mailing address:
  • Phone: 929-283-8307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number0194869
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: