Blanca A Tan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA03544400 Issued in NJ

Practice address

3342 Kennedy Blvd.
Jersey, NJ 07307-4233

Phone

(201) 653-8999

Fax

(201) 653-4477

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336224203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 JOCKEY HOLLOW WAY",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070834157",
            "telephone_number": "908-687-3725",
            "fax_number": "908-686-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3342 KENNEDY BLVD.",
            "city": "JERSEY",
            "state": "NJ",
            "postal_code": "073074233",
            "telephone_number": "201-653-8999",
            "fax_number": "201-653-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "BLANCA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA03544400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheetal S Desai, DDS
• Clifton O Howell, MD
• Rini Palathingal, MD
• Leonor Vivas Ramos, MD
• Shweta Sitaram Shenoy, PT
• Vicente Garcia Tan, M.D.

• Pediatrics Physician in Jersey, NJ
• Providers in Jersey, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.