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1104506005
TETRIS YLIZAH TAN
LONG BRANCH, NJ
NPI
1104506005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-07-25
Last Update Date
2023-07-25
Business Address
TETRIS YLIZAH TAN MD
300 2ND AVE
LONG BRANCH, NJ 07740-6303
Phone number: 732-222-5200
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Mailing Address
TETRIS YLIZAH TAN MD
400 SAIRS AVE APT 7
LONG BRANCH, NJ 07740-5629
Phone number:
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