Tan, Edgardo
Tan, Edgardo is an sole proprietor health care provider with primary practice located at 314 1St Ave , Elizabeth NJ 07206-1659. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Tan, Edgardo can be contacted via phone (908) 353-5280.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 25MA 042112 | New Jersey |
Profile Details
| NPI number | 1356402952 |
|---|---|
| LBN Legal business name | Tan, Edgardo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356402952 | NPPES |
| New Jersey | Other | 01000060500 | AMERICHOICE |
| New Jersey | MEDICAID | 1398709 | AMERICHOICE |
| New Jersey | Other | 1027297 | AMERICHOICE |
| New Jersey | Other | 12278 | AMERICHOICE |
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