Provider Demographics
NPI:1053165035
Name:TAN, FRANCINE ELOUISE CHUA (MD)
Entity type:Individual
Prefix:
First Name:FRANCINE ELOUISE
Middle Name:CHUA
Last Name:TAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E. 149TH STREET
Mailing Address - Street 2:BRONX
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-579-4836
Mailing Address - Fax:
Practice Address - Street 1:445 GERARD AVE # W610
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5865
Practice Address - Country:US
Practice Address - Phone:646-610-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program