Miao Zhen Tan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

012101 Issued in NY

Practice address

775 57TH St
Brooklyn, NY 11220-3505

Phone

(718) 439-6163

NPI assigned

Oct 3, 2007

Last updated

Jun 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1821285834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 57TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 57TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203505",
            "telephone_number": "718-439-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "MIAO ZHEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Tan
• Kevin Tan
• Laura Tan
• Lei Collette Ong Tan
• Lyla Tan, PHARMD, RPH
• Muhammad Abdul Alim Tan, OTR/L
• Rachel Catherine Tan, LMSW
• Reynaldo Go Tan, M.D.
• Robert W Tan, D.D.S.
• Salvador Ruiz Tan Jr., PT

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.