Provider Demographics
NPI:1720046915
Name:TAN, DORIS UY (MD)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:UY
Last Name:TAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DORIS
Other - Middle Name:UY
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:128 MOTT ST
Mailing Address - Street 2:601
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5540
Mailing Address - Country:US
Mailing Address - Phone:212-267-9818
Mailing Address - Fax:212-267-9041
Practice Address - Street 1:128 MOTT ST
Practice Address - Street 2:601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5540
Practice Address - Country:US
Practice Address - Phone:212-267-9818
Practice Address - Fax:212-267-9041
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184609-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist