Provider Demographics
NPI:1790925774
Name:TUN, ELBERT THAN (MD)
Entity Type:Individual
Prefix:
First Name:ELBERT
Middle Name:THAN
Last Name:TUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24324 72ND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2319
Mailing Address - Country:US
Mailing Address - Phone:718-225-2321
Mailing Address - Fax:
Practice Address - Street 1:24324 72ND AVE FL 2
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2319
Practice Address - Country:US
Practice Address - Phone:718-225-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program