Tan, Liza

Tan, Liza is an individual health care provider with primary practice located at 6805 Fresh Pond Rd , Ridgewood NY 11385-5200. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Tan, Liza can be contacted via phone (718) 456-2545.

Contact Information

Primary practice address
6805 Fresh Pond Rd Ridgewood NY 11385-5200
Phone: (718) 456-2545
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 015401 New York

Profile Details

NPI number 1982628764
LBN Legal business name Tan, Liza
Credentials PT, DPT, MA
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Sep 9th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982628764 NPPES
New York MEDICAID 02184710

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