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General NPI Number Information
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NPI Number | 1588895395
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Entity Type | Individual
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Provider Name | JENNY YU TAN ADULT NP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1880 BATHGATE AVENUE
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City | BRONX
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State | NY
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Zip | 10457-4501
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Country | US
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Telephone | 718-294-5891
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Fax | 718-294-2468
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Provider Business Mailing Address
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Address Line | 44 W 28TH ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10001-4212
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Country | US
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Telephone | 212-545-2409
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Fax | 212-463-8411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 30305090
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209007673
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License Number State | IL
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