Provider Demographics
NPI:1083637896
Name:TANG, LIN-LAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LIN-LAN
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27 MOUNTAIN BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5605
Mailing Address - Country:US
Mailing Address - Phone:908-756-6767
Mailing Address - Fax:908-756-5320
Practice Address - Street 1:27 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5605
Practice Address - Country:US
Practice Address - Phone:908-756-6767
Practice Address - Fax:908-756-5320
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA552502080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE71929Medicare UPIN