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MARISSA LUAN TAN DO MPH NPI 1720583818


NPI Information

NPI: 1720583818
Provider Name: MARISSA LUAN TAN, DO, MPH
Classification: Preventive Medicine - 2083A0300X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
504 SOUTH ST
PHILADELPHIA, PA
ZIP 19147
Phone: (800) 805-6989
Get Directions

Marissa Luan Tan, DO, MPH is an addiction medicine preventive medicine in Philadelphia, PA with 6 years of experience. The provider is a physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction. Marissa Luan Tan, DO, MPH NPI is 1720583818. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:2018

The provider's business location address is:

504 SOUTH ST
PHILADELPHIA, PA
ZIP 19147-210
Phone: (800) 805-6989

The NPI 1720583818 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/29/2018 and was last updated on 4/2/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083A0300XPreventive MedicineAddiction MedicineH0087983MARYLANDNo
22083P0901XPreventive MedicinePublic Health & General Preventive MedicineH0087983MARYLANDNo
32083P0901XPreventive MedicinePublic Health & General Preventive MedicineOS020328PENNSYLVANIANo
42083A0300XPreventive MedicineAddiction MedicineOS020328PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.