Jade Marie Tan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D67632 Issued in MD

Practice address

1621 Eastchester Rd
Pediatrics
Bronx, NY 10461-2604

Phone

(718) 405-8048

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1740327790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 E 74TH ST",
            "address_2": "APT 5G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213625",
            "telephone_number": "410-925-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 EASTCHESTER RD",
            "address_2": "PEDIATRICS",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612604",
            "telephone_number": "718-405-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "JADE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "P20266",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D67632",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "258458",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018305900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rana Abdullah Tamraz, M.D.
• Phanthira Christina Tamsukhin, MD
• Brian M Tan, OT
• Bryan Tan, MD
• Francine Elouise Chua Tan, MD
• Jenny Yu Tan, ADULT NP
• Johanna Shea-Fen Tan
• Jun Jine Jack Tan, D.M.D.
• Natalie Patricia Tan, MD
• Sovannary Tan

• Pediatrics Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.