DR. ELIZABETH LISTIANI TAN (NPI# 1346210077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346210077 |
| Entity Type | Individual |
| Full Name | DR. ELIZABETH LISTIANI TAN |
| Credential | M.D. |
| Practice Address |
204 Ark Rd Mount Laurel NJ 08054-3100 |
| Mailing Address |
1295 Route 38 Po Box 479 Hainesport NJ 08036-2702 |
| Practice Telephone | 8568668102 |
| Mailing Telephone | 6099147017 |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2013-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
25MA08161200 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0129267 | 05 | |
| PA | 0017419190001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891778015 | Elizabeth Yap Tan | Dentist | 5270 Newpark Mall Rd., Newark, CA 94560 | 2005-11-22 |
| Street Address |
204 ARK RD |
| City | MOUNT LAUREL |
| State | NJ |
| Zip Code | 08054-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659356905 | Kathleen L Ryan | Specialist | 204 Ark Rd, Ste 206 Lmc I, Mount Laurel, NJ 08054-3100 | 2005-12-09 |
| 1750542270 | Daniel Todd Goldstein | Orthopaedic Surgery | 204 Ark Rd, Suite 105, Mount Laurel, NJ 08054-3100 | 2008-06-17 |
| 1033271820 | Regional Ear Nose and Throat Associates | Otolaryngology | 204 Ark Rd, Suite 102, Mount Laurel, NJ 08054-3100 | 2006-12-15 |
| 1841204849 | Mlfp LLC | Family Medicine | 204 Ark Rd, Suite 103, Mount Laurel, NJ 08054-3100 | 2006-07-28 |
| 1932142858 | Roy Douglas Carlson | Otolaryngology | 204 Ark Rd, Suite 102, Mount Laurel, NJ 08054-3100 | 2006-06-14 |
| 1396712121 | Patricia C Pollan | Nurse Practitioner | 204 Ark Rd, Suite 103, Mount Laurel, NJ 08054-3100 | 2006-03-01 |
| 1164498010 | Gerald D Hayken | Orthopaedic Surgery | 204 Ark Rd, Suite 105, Mount Laurel, NJ 08054 | 2006-02-28 |
| 1386610228 | Gary I Shapiro | Family Medicine | 204 Ark Rd, Suite 103, Mount Laurel, NJ 08054-3100 | 2006-02-28 |
| 1528034469 | Orin K Atlas | Orthopaedic Surgery | 204 Ark Rd, Suite 105, Mount Laurel, NJ 08054 | 2006-02-28 |
| 1699741538 | Joseph F Termini | Family Medicine | 204 Ark Rd, Suite 103, Mount Laurel, NJ 08054-3100 | 2006-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837267 | Samantha Leafey | Behavior Technician | 800 Birchfield Dr., 801, Mount Laurel, NJ 08054 | 2019-12-04 |
| 1306403522 | A-1 Support Coordination Nj | Case Management | 1504 Larchmont Place, Mount Laurel, NJ 08054 | 2019-05-22 |
| 1285129080 | Lincoln Healthcare of New Jersey, LLC | Home Health | 309 Fellowship Rd Ste 100, Mount Laurel, NJ 08054 | 2018-06-25 |
| 1295238400 | Verus Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 200 E Park Dr Ste 600a, Mount Laurel, NJ 08054 | 2018-03-14 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1750893954 | Tishanna D Majette Phd Corporation | Psychologist | 3000 Atrium Way Ste 200, Mount Laurel, NJ 08054 | 2017-10-27 |
| 1700304706 | Arc of Camden County Essex Lane Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5320 Essex Lane, Mt. Laurel, NJ 08054 | 2017-08-30 |
| 1417472861 | Maggie Garin | Dietitian, Registered | 15000 Midlantic Avenue, Suite 101, Mount Laurel, NJ 08054 | 2017-08-07 |
| 1891225363 | New Jersey Lice Treatment LLC | Technician, Other | 500 Birchfield Dr, Suite 503-a, Mount Laurel, NJ 08054 | 2017-06-15 |
| 1225563927 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 761 Grant Ave, Mt Laurel, NJ 08054 | 2017-05-01 |
| Find all providers in zip 08054 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699805705 | Andrew Michael Gargiulo Jr. | Radiology | 210 Ark Road, Mount Laurel, NJ 08054 | 2007-03-07 |
| 1235131707 | Kevin P. Barry | Radiology | 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 2005-08-13 |
| 1982973046 | Travis James Gehringer | Radiology | 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 2011-12-19 |
| 1982831814 | Samir Visanji Chheda | Radiology | 210 Ark Road, Mount Laurel, NJ 08054 | 2009-06-18 |
| 1144455072 | Britton Miller Chan | Radiology | 210 Ark Road, Mount Laurel, NJ 08054 | 2009-05-21 |
| 1598906000 | Joshua Kellerman | Radiology | 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 2009-03-12 |
| 1215108188 | Priyesh Patel | Radiology | 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 2008-03-18 |
| 1710932603 | Larchmont Imaging Associates LLC | Radiology | 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 2006-05-23 |
| 1669474052 | James C. Koss | Radiology | 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 2005-08-15 |
| 1578565966 | Omar Lalani | Radiology | 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 2005-08-15 |
| Find all providers in MOUNT LAUREL | ||||
| City | MOUNT LAUREL |
| Zip Code | 08054 |
Please comment or provide details below to improve the information on DR. ELIZABETH LISTIANI TAN.
| 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.