Provider Demographics
NPI:1750765749
Name:TAN, WEI SEONG (MD)
Entity type:Individual
Prefix:
First Name:WEI SEONG
Middle Name:
Last Name:TAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26901 76TH AVE STE 255
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1433
Mailing Address - Country:US
Mailing Address - Phone:718-470-3460
Mailing Address - Fax:718-343-4642
Practice Address - Street 1:26901 76TH AVE STE 255
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1433
Practice Address - Country:US
Practice Address - Phone:718-470-3460
Practice Address - Fax:718-343-4642
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY294532208000000X, 2080P0207X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics