MEDICARE: HONG J. TAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	1440	NY

General Provider Information

NPI Number	:	1093929432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONG J. TAN

Provider Business Mailing Address
First Line	:	1245 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2016
Country	:	US
Telephone Number	:	718-833-3896
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 CANAL ST
Second Line	:	SUITE #512
City	:	NEW YORK
State	:	NY
Zip	:	10013-4149
Country	:	US
Telephone Number	:	917-237-1153
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/08/2007

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Directions to “ HONG J. TAN ” Practice Location

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