Benito H Tan, MD
Individual provider Active NPI Psychiatry Physician · Millingon, NJ
NPI 1851685291 · NPPES record last updated Jun 2, 2011
Key facts
- NPI
- 1851685291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 25MA02807400 (NJ)
- Practice address
- 6 Meadow View Rd
Millingon, NJ 07946-1349 - Phone
- (908) 660-4528
- NPI assigned
- Jun 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA02807400 | NJ | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA02807400 | NJ | Yes |
Addresses
Primary practice location
6 Meadow View Rd
Millingon, NJ 07946-1349
Mailing address
6 Meadow View Rd
Millingon, NJ 07946-1349
Phone (908) 660-4528
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.