| Kwei Ham Daniel Tan, Do Pllc | |
|
120 Sykes St Groton NY 13073-1231 | |
| (607) 591-5349 | |
| (607) 428-5077 |
| Full Name | Kwei Ham Daniel Tan, Do Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 120 Sykes St, Groton, New York |
| Authorized Official Name and Position | Winda Dickey (BILLING MANAGER) |
| Authorized Official Contact | 7727770333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwei Ham Daniel Tan, Do Pllc 417 S Jensen Rd Vestal NY 13850-3018 Ph: (772) 777-0333 | Kwei Ham Daniel Tan, Do Pllc 120 Sykes St Groton NY 13073-1231 Ph: (607) 591-5349 |
| NPI Number | 1558194035 |
|---|---|
| Provider Enumeration Date | 08/21/2024 |
| Last Update Date | 08/21/2024 |
| Medicare PECOS PAC ID | 4385179316 |
|---|---|
| Medicare Enrollment ID | O20241127000861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558194035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kwei Ham Daniel Tan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326533977 PECOS PAC ID: 5799032082 Enrollment ID: I20220606001302 |
Peter Clark, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 W South St, Groton, NY 13073 Phone: 607-898-3341 Fax: 607-898-3982 |