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General NPI Number Information
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NPI Number | 1235759812
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Entity Type | Organization
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Legal Business Name | YUN & CHIN-TAN PHYSICIANS PLLC
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 14205 ROOSEVELT AVE APT 112
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City | FLUSHING
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State | NY
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Zip | 11354-6005
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Country | US
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Telephone | 718-663-2179
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Fax | 631-684-2401
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Provider Business Mailing Address
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Address Line | 14205 ROOSEVELT AVE APT 112
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City | FLUSHING
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State | NY
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Zip | 11354-6005
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Country | US
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Telephone | 718-663-2179
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Fax | 631-684-2401
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JESSICA MON CHIN-TAN
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Credential | DO
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Telephone | 646-653-0889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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