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1972587103

NPI Code Detail

MEDICARE: EMMANUEL TAN QUIEN MD

MEDICARE: EMMANUEL TAN QUIEN MD

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	207RH0003X	Hematology & Oncology Physician	MD050469L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00025016	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1400	OTHER	PA	BRAVO HEALTH
2	3Y2515	OTHER	PA	HEALTH NET
3	5288554	OTHER	PA	AETNA PPO
4	906433	OTHER	PA	HIGHMARK BLUE SHIELD
5	0164374901	OTHER	PA	AMERICHOICE
6	0416629000	OTHER	PA	INDEPENDENCE BLUE CROSS
7	519042	OTHER	PA	COVENTRY HEALTH AMERICA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	1064956	OTHER	PA	KEYSTONE MERCY HEALTH
11	3215831	OTHER	PA	AETNA HMO

General Provider Information

NPI Number	:	1972587103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL TAN QUIEN MD

Provider Business Mailing Address
First Line	:	2450 W HUNTING PARK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19182-0933
Country	:	US
Telephone Number	:	215-728-2500
Fax Number	:	215-728-3639

Provider Business Practice Location Address
First Line	:	333 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2434
Country	:	US
Telephone Number	:	215-728-2500
Fax Number	:	215-728-3639

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	04/06/2018

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1316944424 — JO ANN CHALAL MD
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1841288776 — STEPHEN E LING MD
Practice Location Address:

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1841273455 — MR. RICHARD JOHN COLASANTE RPH
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Directions to “ EMMANUEL TAN QUIEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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