Provider Demographics
NPI:1578971248
Name:TAN, DANIEL R
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:TAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DANIELE
Other - Middle Name:R
Other - Last Name:MONTE DE RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:CONE HEALTH BEHAVIORAL HEALTH
Mailing Address - Street 2:931 THIRD STREET - 2ND FLOOR RESIDENCY
Mailing Address - City:GREENSBORO
Mailing Address - State:CA
Mailing Address - Zip Code:27405
Mailing Address - Country:US
Mailing Address - Phone:336-832-9626
Mailing Address - Fax:
Practice Address - Street 1:CONE HEALTH BEHAVIORAL HEALTH HOSPITAL
Practice Address - Street 2:700 WALTER REED DRIVE
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403
Practice Address - Country:US
Practice Address - Phone:336-832-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program