Fan, Tracey H
Fan, Tracey H is an individual health care provider with primary practice located at 55 Fruit St # 721J , Boston MA 02114-2696. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Fan, Tracey H can be contacted via phone (617) 726-2000.Contact Information
Primary practice address
55 Fruit St # 721J
Boston MA 02114-2696
Phone: (617) 726-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 287765 | Massachusetts |
Profile Details
| NPI number | 1174055784 |
|---|---|
| LBN Legal business name | Fan, Tracey H |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 2nd, 2017 |
| Last updated | Feb 28th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174055784 | NPPES |
| Massachusetts | Other | SA6390894 | DRIVER LICENSE |
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