| Eric Fan, M.d. Llc | |
|
200 Orchard St Suite 303 New Haven CT 06511-5363 | |
| (203) 867-5600 | |
| (203) 867-5604 |
| Full Name | Eric Fan, M.d. Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Orchard St, New Haven, Connecticut |
| Authorized Official Name and Position | Eric Fan (MANAGER) |
| Authorized Official Contact | 2038675600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric Fan, M.d. Llc 200 Orchard St Suite 303 New Haven CT 06511-5363 Ph: (203) 867-5600 | Eric Fan, M.d. Llc 200 Orchard St Suite 303 New Haven CT 06511-5363 Ph: (203) 867-5600 |
| NPI Number | 1700100781 |
|---|---|
| Provider Enumeration Date | 03/20/2010 |
| Last Update Date | 03/20/2010 |
| Medicare PECOS PAC ID | 0042341190 |
|---|---|
| Medicare Enrollment ID | O20100706000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700100781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 038797 (Connecticut) | Primary |
| Provider Name | Eric Fan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114966561 PECOS PAC ID: 0042345902 Enrollment ID: I20100317000278 |
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