Alfonso Tan MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

115465 Issued in NY

Legal business name

ALFONSO TAN MD PC

Practice address

297 W Main St
Sayville, NY 11782-2523

Phone

(631) 589-2323

Fax

(631) 589-9069

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Alfonso Tan, M.D.

Title

President

Phone

(631) 589-2323

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1548348758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 W MAIN ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822523",
            "telephone_number": "631-589-2323",
            "fax_number": "631-589-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 W MAIN ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822523",
            "telephone_number": "631-589-2323",
            "fax_number": "631-589-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFONSO TAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-589-2323",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "115465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00213052",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Alexandria Adamo, LCSW-R
• Adrian Fields LMHC and Associates, PLLC
• Rachel Eva Aguilar, PSYD
• Isabella Rose Albergo
• Francesca Lara Albertelli, LPN
• Alicia Fuggetta LCSW PLLC
• All About Eyes of Sayville, Inc.
• Donna Marie Allan
• Jessica Alonso
• Joseph Amodemo, PT

• Internal Medicine Physician in Sayville, NY
• Providers in Sayville, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.