Provider Demographics
NPI:1912383787
Name:TAN, YANCHEW
Entity Type:Individual
Prefix:MS
First Name:YANCHEW
Middle Name:
Last Name:TAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 APPLEGARTH ROAD
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08833
Mailing Address - Country:US
Mailing Address - Phone:732-822-9133
Mailing Address - Fax:
Practice Address - Street 1:349 APPLEGARTH ROAD
Practice Address - Street 2:
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08833
Practice Address - Country:US
Practice Address - Phone:732-822-9133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00342300173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist