DR. JUN JINE JACK TAN (NPI# 1114273034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114273034 |
| Entity Type | Individual |
| Full Name | DR. JUN JINE JACK TAN |
| Credential | D.M.D. |
| Practice Address |
3450 Wayne Ave 16l Bronx NY 10467-2510 |
| Practice Telephone | 3479723540 |
| Mailing Telephone | 3479723540 |
| Enumeration Date | 2012-07-29 |
| Last Update Date | 2012-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3450 WAYNE AVE 16L |
| City | BRONX |
| State | NY |
| Zip Code | 10467-2510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013019629 | Amit Punj | Dentist | 3450 Wayne Ave, Apt 13 H, Bronx, NY 10467-2510 | 2006-09-03 |
| 1275064438 | Himali Gandhi | Student in an Organized Health Care Education/Training Program | 3450 Wayne Ave, Bronx, NY 10467-2510 | 2017-03-21 |
| 1992180798 | Gloria Mogado | Registered Nurse | 3450 Wayne Ave, Apt. 8s, Bronx, NY 10467-2510 | 2015-07-22 |
| 1811384134 | Carlos Alberto Millan Cortes | Transplant Surgery | 3450 Wayne Ave, Apt 13r, Bronx, NY 10467-2510 | 2015-04-24 |
| 1477941466 | Elizabeth Richards | Pathology | 3450 Wayne Ave, Apt 21f, Bronx, NY 10467-2510 | 2014-12-30 |
| 1568802304 | Jessica Michelle Pastoriza | Surgery | 3450 Wayne Ave, Apt 6d, Bronx, NY 10467-2510 | 2013-06-25 |
| 1780931097 | Deepika Khanna | Student in an Organized Health Care Education/Training Program | 3450 Wayne Ave, Apt 17b, Bronx, NY 10467-2510 | 2012-08-07 |
| 1174805725 | Jennifer Lobban Roth | Family Medicine | 3450 Wayne Ave, Apt 13h, Bronx, NY 10467-2510 | 2011-09-09 |
| 1376822213 | Christopher Karan Singh | Student in an Organized Health Care Education/Training Program | 3450 Wayne Ave, Apt 10g, Bronx, NY 10467-2510 | 2011-08-10 |
| 1184911232 | Mohammad Pervez | Student in an Organized Health Care Education/Training Program | 3450 Wayne Ave, Apartment 20 P, Bronx, NY 10467-2510 | 2011-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535505 | Maxwell Ennist | Massage Therapist | 210 Bedford Park Blvd, Bronx, NY 10467 | 2020-10-09 |
| 1144854431 | Ny Metro Dental, PC | Dentist | 55 Mosholu Parkway North, Bronx, NY 10467 | 2020-02-26 |
| 1386277960 | Rhonda Ellen Nayberg | Occupational Therapist | Montefiore Medical Center Occupational Therapy Dept, 111 E 210 Street Ground Floor Blue Zone, Bronx, NY 10467 | 2020-02-21 |
| 1013568153 | Jaime Luis Betancourt | Nurse Practitioner | Sickle Cell Clinic, 3400 Bainbridge Avenue, Bronx, NY 10467 | 2019-09-20 |
| 1023662616 | Bronx Jewish Community Council Home Attendant Services | Home Health | 2930 Wallace Ave., Bronx, NY 10467 | 2019-07-31 |
| 1831755321 | Felix Medrano | Taxi | 3106 Webster Ave, Bronx, NY 10467 | 2019-05-10 |
| 1700363108 | Danaies Guzman | Occupational Therapist | 2410 Barker Avenue Apt 11a, Bronx, New York, NY 10467 | 2018-07-27 |
| 1538672175 | Carolina Duque-toro | Speech-Language Pathologist | 4251, 341 E 207th St, Bronx, NY 10467 | 2017-11-06 |
| 1255853727 | Jessica Perkiss | Social Worker | 750 Tilden St., Astor Services for Children and Families, Bronx, NY 10467 | 2017-07-17 |
| 1386166221 | Erica Santos | Licensed Practical Nurse | 3273 Parkside Place, Apt 5g, Bronx, NY 10467 | 2017-07-12 |
| Find all providers in zip 10467 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151041 | Islam Moheisen | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S Rm 6s11, Bronx, NY 10461-1197 | 2020-10-15 |
| 1942814710 | Wai Bun Liew | Student in an Organized Health Care Education/Training Program | 234 E 149th St Ste 2a8, Bronx, NY 10451-5504 | 2020-08-31 |
| 1013520444 | Aireni A Sterling Lachapel | Student in an Organized Health Care Education/Training Program | 3212 Decatur Ave Apt 3a, Bronx, NY 10467-4223 | 2020-08-25 |
| 1023629748 | Shellsea Portillo Canales | Student in an Organized Health Care Education/Training Program | 4222 3rd Ave, Bronx, NY 10457-4502 | 2020-08-14 |
| 1013527753 | Cherine Awad | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue, Bronxcare Health System, Bronx, NY 10457 | 2020-08-07 |
| 1962012161 | Yinelka Grisel Silverio De Castro | Student in an Organized Health Care Education/Training Program | 234 E 149th St Dept Internal, Bronx, NY 10451-5504 | 2020-08-03 |
| 1164031316 | Patrick Michael Biskupski | Student in an Organized Health Care Education/Training Program | 234 E 149th St Fl 8, Bronx, NY 10451-5504 | 2020-07-23 |
| 1023626926 | Tolulope Oyinlola Olorunsogo | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue - Bronxcare Health System, Departmen, Suite 6h, Bronx, NY 10457 | 2020-07-16 |
| 1598373615 | Sharan Mirchandani | Student in an Organized Health Care Education/Training Program | 4422 3rd Ave Bldg 4th, Bronx, NY 10457-2545 | 2020-07-15 |
| 1750999801 | Kalyan C Chilukuri | Student in an Organized Health Care Education/Training Program | Bronxcare Hospital Center, 1650 Grand Concourse, Bronx, NY 10457 | 2020-07-15 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.